Endoscope and endoscope system thereof

ABSTRACT

Guide wire fixing means is provided for an insertion portion of an endoscope, and a guide wire is releasably engaged when inserting/removing a therapeutic instrument running on the guide wire with a distal end portion of the guide wire inserted into a therapeutic instrument insertion channel of the endoscope being led out from a distal end opening portion of the channel.

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This is a Continuation Application of PCT Application No.PCT/JP01/03286, filed Apr. 17, 2001, which was not published under PCTArticle 21(2) in English.

[0002] This application is based upon and claims the benefit of priorityfrom the prior Japanese Patent Applications No. 2000-115355, filed Apr.17, 2000, No. 2000-128262, filed Apr. 27, 2000, No. 2000-145530, filedMay 17, 2000; and No. 2001-104390, filed Apr. 3, 2001, the entirecontents of all of which are incorporated herein by reference.

BACKGROUND OF THE INVENTION

[0003] 1. Field of the Invention

[0004] The present invention relates to an endoscope and an endoscopesystem with which can be replaced a therapeutic instrument by using aguide wire in endoscopy or endoscopic surgery of pancreaticobiliaryducts in particular.

[0005] 2. Description of the Related Art

[0006] In recent years, use of an endoscopic treatment for treatment ofa disorder in an alimentary canal system and a pancreaticobiliary ductsystem is increasing. As the current treatment for thepancreaticobiliary duct system using an endoscope, there is a diagnostictreatment for endoscopically imaging a bile duct or a pancreatic duct aswell as therapeutic treatment for collecting a bile stone existing in acholedoch duct by a balloon or a gripping therapeutic instrument.

[0007] Further, in the endoscopic treatment for a pancreatic duct, abile duct or a hepatic duct, an end of an insertion portion of theendoscope is inserted to the vicinity of the duodenal papilla, and atherapeutic instrument such as a catheter is then selectively insertedinto the pancreatic duct or the bile duct with a guide wire as a guidein radioscopy.

[0008] Furthermore, when performing endoscopic treatment for apancreatic duct, a bile duct or a hepatic duct by using the endoscope,the end of the insertion portion of the endoscope is usually inserted tothe vicinity of the duodenal papilla, and a therapeutic instrument suchas a catheter is then generally selectively inserted into the pancreaticduct or the bile duct with the guide wire as a guide, in radioscopy.

[0009] Specifically, the following operation is carried out. At first,after an end portion 903 of an insertion portion 902 of an endoscope 901shown in FIGS. 114A and 114B is inserted to the vicinity of duodenalpapilla in advance, a catheter 904 is inserted into a therapeuticinstrument insertion channel of the endoscope 901, and an end portion904 a of the catheter 904 is endoscopically inserted into the pancreaticduct or the bile duct. Then, a guide wire 905 is inserted from a mouthring 904 b of the inserted catheter 904 on the base end side.

[0010] Thereafter, in radioscopy, it is confirmed that the guide wire905 is correctly inserted into the pancreatic duct or the bile duct, andthe operation for pulling out the catheter 904 from the therapeuticinstrument insertion channel of the endoscope 901 is carried out whilegripping the base end side of the guide wire 905 by hand as shown inFIG. 114A. During this operation, as shown in FIG. 114B, when the endportion 904 a of the catheter 904 protrudes from a channel openingportion 907 on an operation portion 906 side of the endoscope 901, theguide wire 905 in the vicinity of the channel opening portion 907 of theendoscope 901 is gripped, and the catheter 904 is completely pulled outof the endoscope 901.

[0011] Subsequently, the base end side of the guide wire 905 is insertedinto an insertion hole of another therapeutic instrument, and thistherapeutic instrument is inserted into the therapeutic instrumentinsertion channel of the endoscope 901 so as to be guided by the guidewire 905. Thereafter, the above-described operation is repeated inaccordance with a number of times of replacement of the therapeuticinstrument.

[0012] The therapeutic instrument used for such treatment is generallyset to have a length which is not less than 190 cm by taking a length ofthe endoscope 901 into consideration.

[0013] Furthermore, since a length which exceeds a combination of alength of the endoscope 901 and that of the therapeutic instrument isrequired for the guide wire 905, at least approximately 400 cm isnecessary.

[0014] Moreover, for example, U.S. Pat. No. 5,921,971 discloses a bileduct catheter which can be rapidly replaced by providing an openingportion in the longitudinal direction between an end portion of a guidewire lumen and a base end portion in a catheter shaft.

[0015] Meanwhile, in case of observing/treating the pancreaticobiliaryduct system by using the endoscope 901, when a therapeutic instrumentsuch as the catheter 904 is inserted into the therapeutic instrumentinsertion channel of the endoscope 901 and used, the guide wire 905 isinserted into the therapeutic instrument. Therefore, when thetherapeutic instrument is moved with respect to the endoscope 901, theguide wire 905 also simultaneously moves. Thus, for example, whenreplacing the therapeutic instrument with the guide wire 905 as a guidein the state where the end of the guide wire 905 is inserted into thepapilla, the guide wire 905 must be constantly gripped on the operationportion 906 side of the endoscope 901 in order to maintain the end ofthe guide wire 905 being inserted into the papilla.

[0016] In addition, during use of the conventional endoscope 901, it isnecessary to simultaneously carry out the two operations, i.e., pullingout the therapeutic instrument with respect to the therapeuticinstrument insertion channel of the endoscope 901 while inserting theguide wire 905 by the same amount in the operation for replacing thetherapeutic instrument, or similarly inserting the therapeuticinstrument into the therapeutic instrument insertion channel whilepulling out the guide wire 905 by the same movement amount. Therefore,that operation is complicated and troublesome.

[0017] Additionally, since the guide wire 905 has a length ofapproximately 400 cm, it is difficult to handle the guide wire 905 insuch a manner that the guide wire 905 does not come into contact with anunclean area such as the floor in a small endoscope room.

[0018] Further, since the therapeutic instrument can not be replacedunless the entire length of the guide wire 905 is moved, the timerequired for replacement of the therapeutic instrument itself maypossibly be prolonged. Therefore, there is a drawback that the operationfor replacing the therapeutic instrument takes longer.

[0019] Furthermore, it is difficult for one operator to carry out theoperation for replacing the therapeutic instrument, and at least twoassistants are required in an operating room. Therefore, there occurs aproblem that the personnel cost increases and the pecuniary burden on ahospital or a patient thereby increases.

[0020] Moreover, as in U.S. Pat. No. 5,921,971, in the case of thecatheter having the opening portion in the longitudinal direction beingprovided between the end portion and the base end portion of the guidewire lumen in the catheter shaft, the operation for providing theopening portion in the longitudinal direction to the conventionalcontrasting catheter. Thus, there is a drawback that the manufacturingcost is higher than that of the conventional contrasting catheter.

[0021] In addition, an outside diameter of the shaft must be increasedin order to compensate for a reduction in rigidity of the catheter shaftcaused due to provision of a slit, or a material of the shaft must behardened. Therefore, an increase in diameter of the shaft may possiblylead to deterioration of the working property of an operator since theinsertion ability in the channel of the endoscope is degraded.

[0022] Additionally, since the treatment for the pancreaticobiliary ductsystem requires specialist techniques, preference of the operator withrespect to therapeutic instruments is divided in particular. Further,changing the therapeutic instruments depending on conditions of apatient is frequently carried out. However, usable therapeuticinstruments are restricted in this prior art by itself, and theselection range of the operator is disadvantageously lost.

[0023] In view of the above-described problems, it is an object of thepresent invention to provide an endoscope apparatus by which atherapeutic instrument can be replaced in a shorter time and thereplacement operation can be performed by one operator without impairingthe conventional operation method of a therapeutic instrument or theoperation sense.

BRIEF SUMMARY OF THE INVENTION

[0024] According to the present invention, there is provided anendoscope in which a therapeutic instrument insertion channel isprovided in an insertion portion which is inserted into a celom and anend opening portion of the therapeutic instrument insertion channel isarranged in the vicinity of an end of the insertion portion, wherein,when inserting/removing a therapeutic instrument traveling on a guidewire with an end portion of the guide wire inserted through thetherapeutic instrument insertion channel being led out from the endopening portion of the therapeutic instrument insertion channel, guidewire fixing means for releasably engaging the guide wire is provided inthe vicinity of the end portion of the insertion portion.

[0025] Further, according to the present invention, there is provided anendoscope comprising: an insertion portion inserted into a celom; anoperation portion connected to an end portion of the insertion portionon a front side; and a therapeutic instrument elevator base which isarranged at an end portion of the insertion portion and can be operatedby the operation portion, wherein a slit enabling engagement of only aguide wire by raising the guide wire by operating the therapeuticinstrument elevator base is provided at a top portion on a guide planeof the therapeutic instrument elevator base.

[0026] Furthermore, according to the present invention, there isprovided an endoscope system comprising: an endoscope in which atherapeutic instrument insertion channel is provided in an insertionportion inserted into a celom and an end opening portion of thetherapeutic instrument insertion channel is provided in the vicinity ofan end of the insertion portion and a therapeutic instrument insertionport as an opening portion of the therapeutic instrument insertionchannel is provided on a front side of the operation portion; a guidewire which can pass through the therapeutic instrument insertionchannel; and a therapeutic instrument which has a duct through which theguide wire can be inserted and which can be inserted through thetherapeutic instrument insertion channel, wherein the therapeuticinstrument has a protrusion length from the end opening portion which isrequired for the treatment in the state where the therapeutic instrumentis inserted into the therapeutic instrument insertion channel and aprotrusion length from the therapeutic instrument insertion portrequired for the operation on the front side, guide wire fixing meanswhich releasably engaging the guide wire when inserting/removing thetherapeutic instrument traveling on the guide wire with an end portionof the guide wire inserted through the therapeutic instrument insertionchannel being led out from the end opening portion is provided in thevicinity of the end portion of the insertion portion, and the guide wirepulls the therapeutic instrument end portion toward the operationportion front side from a position of the engagement and has a lengthprotruding from the end portion of the therapeutic instrument on thefront side when being engaged by the guide wire fixing means.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING

[0027]FIG. 1 is a perspective view showing a schematic structure of anentire system of an endoscope apparatus in which an endoscope andvarious kinds of external devices are incorporated according to a firstembodiment of the present invention;

[0028]FIG. 2 is a vertical cross-sectional view showing a primary partof an inner structure of an end portion of an insertion portion in theendoscope according to the first embodiment;

[0029]FIG. 3 is a plane view showing a primary part of an elevator baseactuation mechanism included in an operation portion in the endoscopeaccording to the first embodiment;

[0030]FIG. 4 is a vertical cross-sectional view showing a primary partof the elevator base actuation mechanism included in the operationportion in the endoscope according to the first embodiment;

[0031]FIG. 5 is a vertical cross-sectional view showing a primary partof the inner structure of the end portion of the insertion portion inthe endoscope according to the first embodiment;

[0032]FIG. 6A is a vertical cross-sectional view of a primary partshowing the engagement state of a guide wire in the endoscope accordingto the first embodiment;

[0033]FIG. 6B is a front view of a therapeutic instrument elevator basein the endoscope according to the first embodiment;

[0034]FIG. 7A is a perspective view of a primary part showing aschematic structure of an end portion of an insertion portion in anendoscope according to a second embodiment of the present invention;

[0035]FIG. 7B is a plane view showing the end portion of the insertionportion in the endoscope according to the second embodiment;

[0036]FIG. 7C is a vertical cross-sectional view of a primary partshowing the state in which a guide wire in the endoscope is moved to anengagement position according to the second embodiment;

[0037]FIG. 7D is a vertical cross-sectional view of a primary partshowing a modification of the first and second embodiments;

[0038]FIG. 8A is a cross-sectional view of a primary part showing aschematic structure of an end portion of an insertion portion in anendoscope according to a third embodiment of the present invention;

[0039]FIG. 8B is a plane view of the end portion of the insertionportion in the endoscope according to the third embodiment;

[0040]FIG. 8C is a plane view of the end portion of the insertionportion showing the state in which the guide wire in the endoscope ismoved to an engagement position according to the third embodiment;

[0041]FIG. 9 is a front view showing a therapeutic instrument elevatorbase according to a fourth embodiment of the present invention;

[0042]FIG. 10A is a front view of a therapeutic instrument elevator basein an endoscope according to a fifth embodiment of the presentinvention;

[0043]FIG. 10B is a vertical cross-sectional view of the therapeuticinstrument elevator base in the endoscope according to the fifthembodiment;

[0044]FIG. 11A is a rear view of a therapeutic instrument elevator basein an endoscope according to a sixth embodiment of the presentinvention;

[0045]FIG. 11B is an enlarged vertical cross-sectional view showing awire engagement groove of the therapeutic instrument elevator base inthe endoscope according to the sixth embodiment;

[0046]FIG. 12A is a front view showing a first modification of thetherapeutic instrument elevator base according to the sixth embodiment;

[0047]FIG. 12B is a front view showing a second modification of thetherapeutic instrument elevator base according to the sixth embodiment;

[0048]FIG. 12C is a vertical cross-sectional view of a primary partshowing a third modification of the therapeutic instrument elevator baseaccording to the sixth embodiment;

[0049]FIG. 13 is a vertical cross-sectional view of a primary partshowing the set-down state of the therapeutic instrument elevator basewith a guide catheter being inserted in an endoscope according to aseventh embodiment of the present invention;

[0050]FIG. 14 is a vertical cross-sectional view of a primary partshowing the set-up state of the therapeutic instrument elevator baseaccording to the seventh embodiment;

[0051]FIG. 15A is a front view of the therapeutic instrument elevatorbase according to the seventh embodiment;

[0052]FIG. 15B is a rear view of the therapeutic instrument elevatorbase according to the seventh embodiment;

[0053]FIG. 16 is a vertical cross-sectional view of a primary partshowing a structure of a therapeutic instrument elevator base of anendoscope according to an eighth embodiment of the present invention;

[0054]FIG. 17 is a vertical cross-sectional view of a primary partshowing an ideal guide wire fixed state in the therapeutic instrumentelevator base in the endoscope according to the eighth embodiment;

[0055]FIG. 18 is a vertical cross-sectional view showing the guide wirefixed state when irregularities occurred due to processing in thetherapeutic instrument elevator base in the endoscope according to theeighth embodiment;

[0056]FIG. 19 is a vertical cross-sectional view of a primary partshowing a guide wire fixed state according to a ninth embodiment of thepresent invention;

[0057]FIG. 20 is a vertical cross-sectional view showing the state whena guide wire is fixed at an end portion of a conventional endoscope;

[0058]FIG. 21 is a plane view of a primary part of an elevator baseactuation mechanism showing an 11th embodiment according to the presentinvention;

[0059]FIG. 22A is a vertical cross-sectional view of the elevator baseactuation mechanism according to the 11th embodiment;

[0060]FIG. 22B is a perspective view of a primary part showing anelevator base operation knob of the elevator base actuation mechanismaccording to the 11th embodiment;

[0061]FIG. 22C is a perspective view showing a deterrence reinforcementmember of a braking mechanism of the elevator base actuation mechanismaccording to the 11th embodiment;

[0062]FIG. 22D is a plane view of the deterrence reinforcement membershowing the embedded state of a friction resistance member of theelevator base actuation mechanism according to the 11th embodiment;

[0063]FIG. 23 is a plane view showing a deterrence reinforcement memberof a braking mechanism in a first modification of the 11th embodiment;

[0064]FIG. 24 is a plane view of a primary part of an elevator baseactuation mechanism showing a tenth embodiment according to the presentinvention;

[0065]FIG. 25A is a vertical cross-sectional view of the elevator baseactuation mechanism showing the tenth embodiment;

[0066]FIG. 25B is a vertical cross-sectional view of a primary partshowing the state in which an operation lever of the set-up actuationmechanism of the elevator base actuation mechanism according to thetenth embodiment is elastically deformed;

[0067]FIG. 26 is a perspective view showing a stopper member of theelevator base actuation mechanism according to the tenth embodiment;

[0068]FIG. 27 is an explanatory view for explaining the operation of theelevator base actuation mechanism according to the tenth embodiment;

[0069]FIG. 28 is a vertical cross-sectional view of a primary partshowing a modification of the tenth embodiment;

[0070]FIG. 29A is a perspective view showing an end portion of aninsertion portion of an endoscope according to a 12th embodiment of thepresent invention;

[0071]FIG. 29B is a plane view showing an actual endoscopic screen whena guide wire of the endoscope is fixed according to the 12th embodiment;

[0072]FIG. 30 is a vertical cross-sectional view showing an innerstructure of an end portion in the insertion portion of the endoscopeaccording to the 12th embodiment;

[0073]FIG. 31A is a plane view showing a guide wire according to a 13thembodiment of the present invention;

[0074]FIG. 31B is a plane view showing a first modification of the guidewire according to the 13th embodiment;

[0075]FIG. 31C is a plane view showing a second modification of theguide wire according to the 13th embodiment;

[0076]FIG. 32A is a vertical cross-sectional view of a primary partshowing the set-down state of a therapeutic instrument elevator basewhen a guide wire is fixed according to a 14th embodiment of the presentinvention;

[0077]FIG. 32B is a vertical cross-sectional view of a primary partshowing the set-down state of a therapeutic instrument elevator basewhen a conventional guide wire is fixed;

[0078]FIG. 33A is a perspective view of a primary part showing aschematic structure of an end portion of an insertion portion in anendoscope according to a 15th embodiment of the present invention;

[0079]FIG. 33B is a vertical cross-sectional view of a primary partshowing the inner structure of an end portion of an insertion section inthe endoscope according to the 15th embodiment;

[0080]FIG. 34 is a perspective view of a primary part showing amodification of an end cover of the insertion portion in the endoscopeaccording to the 15th embodiment;

[0081]FIG. 35A is a horizontal cross-sectional view showing the set-downstate of a therapeutic instrument elevator base seen from an end portionof an endoscope according to a 16th embodiment of the present invention;

[0082]FIG. 35B is a horizontal cross-sectional view showing the state inwhich the therapeutic instrument elevator base is raised in theendoscope according to the 16th embodiment;

[0083]FIG. 36A is a horizontal cross-sectional view showing the set-downstate of a therapeutic instrument elevator base seen from an end portionof an endoscope according to a 17th embodiment of the present invention;

[0084]FIG. 36B is a horizontal cross-sectional view showing the state inwhich the therapeutic instrument elevator base is raised in theendoscope according to the 17th embodiment;

[0085]FIG. 37A is a plane view showing an end portion of an insertionportion in an endoscope according to an 18th embodiment of the presentinvention;

[0086]FIG. 37B is a vertical cross-sectional view of a primary partshowing the inner structure of the end portion of the insertion portionin the endoscope according to the 18th embodiment;

[0087]FIG. 37C is a vertical cross-sectional view of a primary partshowing the state before fixing a guide wire in the endoscope accordingto the 18th embodiment;

[0088]FIG. 37D is a vertical cross-sectional view of a primary stateshowing the state in which the guide wire is fixed in the endoscopeaccording to the 18th embodiment;

[0089]FIG. 38 is a vertical cross-sectional view of a primary partshowing an inner structure of an end portion of an insertion portion inan endoscope according to a 19th embodiment of the present invention;

[0090]FIG. 39 is a perspective view showing a therapeutic instrumentelevator base in the endoscope according to the 19th embodiment;

[0091]FIG. 40 is a vertical cross-sectional view of a primary partshowing the engagement state of a guide wire in an endoscope accordingto a 20th embodiment of the present invention;

[0092]FIG. 41A is a perspective view showing a schematic structure of anend portion of an insertion portion in an endoscope according to a 21stembodiment of the present invention;

[0093]FIG. 41B is a perspective view showing a guide wire fixture in theendoscope according to the 21st embodiment;

[0094]FIG. 42 is a vertical cross-sectional view showing the set-downstate of a therapeutic instrument elevator base according to a 22ndembodiment of the present invention;

[0095]FIG. 43 is a vertical cross-sectional view showing the set-upstate of the therapeutic instrument elevator base according to the 22ndembodiment;

[0096]FIG. 44 is a horizontal cross-sectional view of a primary partshowing an inner structure of an end portion in an insertion portion inthe endoscope according to the 22nd embodiment;

[0097]FIG. 45 is a schematic block diagram of an endoscope showing a23rd embodiment of the present invention;

[0098]FIG. 46A is a perspective view of a primary part showing the statein which a guide wire fixture is held in a standby position in anendoscope according to a 24th embodiment;

[0099]FIG. 46B is a perspective view of a primary part showing a fixedstate of a guide wire;

[0100]FIG. 47A is a perspective view of a primary part showing the statein which a guide wire fixture is held at a standby position in anendoscope according to a 25th embodiment of the present invention;

[0101]FIG. 47B is a perspective view of a primary part showing the fixedstate of the guide wire;

[0102]FIG. 48 is a plane view of an end portion of an insertion portionin an endoscope according to a 26th embodiment of the present invention;

[0103]FIG. 49 is a vertical cross-sectional view of a primary partshowing the state in which a guide wire fixture is held at a standbyposition in the endoscope according to the 26th embodiment;

[0104]FIG. 50 is a vertical cross-sectional view of a primary partshowing the fixed state of the guide wire by the guide wire fixture inthe endoscope according to the 26th embodiment;

[0105]FIG. 51 is a perspective view of a primary part showing a secondmodification according to the 11th embodiment;

[0106]FIG. 52 is a schematic block diagram of a primary part showing a27th embodiment of the present invention;

[0107]FIG. 53 is a vertical cross-sectional view showing an innerstructure of an end portion in the endoscope according to the 27thembodiment;

[0108]FIG. 54A is a perspective view showing a guide wire engagementmember according to the 27th embodiment;

[0109]FIG. 54B is a perspective view showing a rack gear at an end of atow wire in the endoscope according to the 27th embodiment;

[0110]FIG. 55 is a perspective view showing a modification of the guidewire engagement member in the 27th embodiment;

[0111]FIG. 56A is a vertical cross-sectional view of a primary partshowing an inner structure of an end portion of an insertion portion inan endoscope according to a 28th embodiment of the present invention;

[0112]FIG. 56B is a perspective view showing a guide wire engagementmember in the endoscope according to the 28th embodiment;

[0113]FIG. 57A is a vertical cross-sectional view of a primary partshowing an inner structure of an end portion of an insertion portion inan endoscope according to a 29th embodiment of the present invention;

[0114]FIG. 57B is a vertical cross-sectional view of a primary partshowing the state in which a guide wire fixing elevator base of anelevator base actuation mechanism is held at a standby position in theendoscope according to the 29th embodiment;

[0115]FIG. 57C is a vertical cross-sectional view of a primary partshowing the state in which the guide wire fixing elevator base of theelevator base actuation mechanism is moved to an engagement position ofthe guide wire in the endoscope according to the 29th embodiment;

[0116]FIG. 58A is a perspective view showing a guide wire fixingelevator base of a therapeutic instrument elevator base according to a30th embodiment of the present invention;

[0117]FIG. 58B is a perspective view showing a reception portion of thetherapeutic instrument elevator base according to the 30th embodiment;

[0118]FIG. 58C is a perspective view showing a guide wire fixingelevator base according to the 30th embodiment;

[0119]FIG. 59A is a perspective view showing a modification of the guidewire fixing elevator base in the endoscope according to the 29thembodiment;

[0120]FIG. 59B is a perspective view showing a second modification ofthe guide wire fixing elevator base;

[0121]FIG. 60A is a vertical cross-sectional view of a primary partshowing the state in which a guide wire fixing elevator base of anelevator base actuation mechanism is held at a standby positionaccording to a 31st embodiment of the present invention;

[0122]FIG. 60B is a vertical cross-sectional view of a primary partshowing the state in which the guide wire fixing elevator base of theelevator base actuation mechanism is moved to an engagement position ofa guide wire;

[0123]FIG. 61A is a perspective view showing the guide wire fixingelevator base on a therapeutic instrument elevator base in the endoscopeaccording to the 31st embodiment;

[0124]FIG. 61B is a perspective view showing the operation state of theguide wire fixing elevator base of the elevator base actuation mechanismin the endoscope according to the 31st embodiment;

[0125]FIG. 62 is a relational view showing the relationship between aset-up angle of the therapeutic instrument elevator base and a set-upangle of the guide wire fixing elevator base in the endoscope accordingto the 31st embodiment;

[0126]FIG. 63 is a perspective view showing a modification of the guidewire fixing elevator base in the endoscope according to the 31stembodiment;

[0127]FIG. 64 is a perspective view of an end portion of an insertionportion in an endoscope according to a 32nd embodiment of the presentinvention;

[0128]FIG. 65 is a vertical cross-sectional view of a primary partshowing the state in which a guide wire fixing elevator base of anelevator base actuation mechanism is moved to an engagement position ofa guide wire according to the 32nd embodiment;

[0129]FIG. 66A is a plane view showing an operation portion of anendoscope according to a 33rd embodiment of the present invention;

[0130]FIG. 66B is a plane view showing an insertion portion of theendoscope according to the 33rd embodiment;

[0131]FIG. 66C is a vertical cross-sectional view of a primary partshowing an inner structure of the insertion portion of the endoscopeaccording to the 33rd embodiment;

[0132]FIG. 66D is a perspective view showing a cam member in theendoscope according to the 33rd embodiment;

[0133]FIG. 67A is a plane view showing a first modification of anoperation portion in the endoscope according to the 33rd embodiment;

[0134]FIG. 67B is a plane view showing a second modification of theoperation portion in the endoscope according to the 33rd embodiment;

[0135]FIG. 68A is a vertical cross-sectional view of a primary partshowing an inner structure of an end portion of an insertion portion inan endoscope according to a 34th embodiment of the present invention;

[0136]FIG. 68B is a vertical cross-section of a primary part showing theoperation state of a guide wire fixture in the endoscope according tothe 34th embodiment;

[0137]FIG. 69A is a vertical cross-sectional view of a primary partshowing an inner structure of an end portion of an insertion portion inan endoscope according to a 35th embodiment of the present invention;

[0138]FIG. 69B is a vertical cross-sectional view of a primary partshowing the operation state of a guide wire fixture in the endoscopeaccording to the 35th embodiment;

[0139]FIG. 69C is a perspective view showing a torque transmissionmember in the endoscope according to the 35th embodiment;

[0140]FIG. 70A is a perspective view of a primary part showing aschematic structure of an end portion of an insertion portion in anendoscope according to a 36th embodiment of the present invention;

[0141]FIG. 70B is a vertical cross-sectional view of a primary partshowing an inner structure of the end portion of the insertion portionin the endoscope according to the 36th embodiment;

[0142]FIG. 70C is a vertical cross-sectional view of a primary partshowing a state in which a guide wire fixing elevator base is moved toan engagement position of a guide wire in the endoscope according to the36th embodiment;

[0143]FIG. 71 is a plane view of a primary part showing a state in whicha guide wire fixing portion is held at a standby position in anendoscope according to a 37th embodiment of the present invention;

[0144]FIG. 72 is a plane view of a primary part showing a fixed state ofa guide wire in the endoscope according to the 37th embodiment;

[0145]FIG. 73 is a plane view showing a modification of a fixed state ofan end portion of the guide wire fixing portion in the endoscopeaccording to the 37th embodiment;

[0146]FIG. 74A is a perspective view of a primary part showing aschematic structure of an end portion of an insertion portion in anendoscope according to a 38th embodiment of the present invention;

[0147]FIG. 74B is a perspective view of a primary part showing astructure of a guide wire fixture in the endoscope according to the 38thembodiment;

[0148]FIG. 74C is a vertical cross-sectional view of a primary partshowing the structure of the guide wire fixture in the endoscopeaccording to the 38th embodiment;

[0149]FIG. 75 is a vertical cross-sectional view of a primary partshowing a modification of the endoscope according to the 38thembodiment;

[0150]FIG. 76 is a perspective view showing an operation portion on thefront side in an endoscope according to a 39th embodiment of the presentinvention;

[0151]FIG. 77A is a perspective view showing the state before fixing theguide wire in the endoscope according to the 39th embodiment;

[0152]FIG. 77B is a perspective view showing the state after fixing theguide wire in the endoscope according to the 39th embodiment;

[0153]FIG. 78 is a vertical cross-sectional view showing the innerstructure of the end portion of the insertion portion in the endoscopeaccording to the 39th embodiment;

[0154]FIG. 79A is a perspective view showing the state in which a snareis closed according to the 39th embodiment;

[0155]FIG. 79B is a perspective view showing the state in which thesnare is opened in the endoscope according to the 39th embodiment;

[0156]FIG. 80 is an exploded perspective view showing a guide wirefixing member according to the 39th embodiment;

[0157]FIG. 81 is a perspective view showing the state in which a guidewire fixing member is attached to an end portion of an insertion portionof an endoscope in an endoscope apparatus according to a 40th embodimentof the present invention;

[0158]FIG. 82 is a perspective view showing the structure of the guidewire fixing member in the endoscope apparatus according to the 40thembodiment;

[0159]FIG. 83A is a perspective view showing the state before atherapeutic instrument elevator base is raised when raising atherapeutic instrument other than a guide wire by using a guide wirefixing member in the endoscope apparatus according to the 40thembodiment;

[0160]FIG. 83B is a perspective view showing the state in which thetherapeutic instrument elevator base is raised in the endoscopeapparatus according to the 40th embodiment;

[0161]FIG. 84A is a perspective view showing the state before thetherapeutic instrument elevator base is raised when raising the guidewire by using the guide wire fixing member in the endoscope apparatusaccording to the 40th embodiment;

[0162]FIG. 84B is a perspective view showing the state in which thetherapeutic instrument elevator base is raised in the endoscopeapparatus according to the 40th embodiment;

[0163]FIG. 85 is a vertical cross-sectional view of a primary partshowing the state in which the guide wire is engaged by using the guidewire fixing member in the endoscope apparatus according to the 40thembodiment;

[0164]FIG. 86A is a perspective view of a primary part showing thestructure of a guide wire fixing member according to a 41st embodimentof the present invention;

[0165]FIG. 86B is a plane view showing an attachment portion of theguide wire fixing member according to the 41st embodiment;

[0166]FIG. 87A is a vertical cross-sectional view of a primary partshowing an attachment mechanism for the guide wire fixing member in thestate before attaching the guide wire fixing member to the end portionof the insertion portion of the endoscope in the endoscope apparatusaccording to the 41st embodiment;

[0167]FIG. 87B is a vertical cross-sectional view of a primary artshowing the state in which the guide wire fixing member is attached tothe end portion of the insertion portion of the endoscope in theendoscope apparatus according to the 41st embodiment;

[0168]FIG. 88A is a perspective view showing the state before atherapeutic instrument elevator base is raised when raising atherapeutic instrument other than a guide wire by using the guide wirefixing member in the endoscope apparatus according to the 41stembodiment;

[0169]FIG. 88B is a perspective view showing the state in which thetherapeutic instrument elevator base is raised in the endoscopeapparatus according to the 41st embodiment;

[0170]FIG. 89A is a perspective view showing the state before thetherapeutic instrument elevator base is raised when raising the guidewire by using the guide wire fixing member in the endoscope apparatusaccording to the 41st embodiment;

[0171]FIG. 89B is a perspective view showing the state in which thetherapeutic instrument elevator base is raised in the endoscopeapparatus according to the 41st embodiment;

[0172]FIG. 90 is a plane view of a primary part showing the state inwhich a guide wire fixing member is attached to an end portion of aninsertion portion of an endoscope in an endoscope apparatus according toa 42nd embodiment of the present invention;

[0173]FIG. 91 is a plane view of a primary part showing an attachmentmechanism of the guide wire fixing member in the endoscope apparatusaccording to the 42nd embodiment;

[0174]FIG. 92A is a plane view of a primary part showing an attachmentmechanism of the guide wire fixing member in the endoscope apparatusaccording to the 42nd embodiment;

[0175]FIG. 92B is an explanatory view for explaining the state in whichthe endoscope apparatus according to the 42nd embodiment is insertedinto a celom;

[0176]FIG. 93A is a plane view of a primary part showing a guide wirefixing member main body having a guide wire identification mechanismportion and a click mechanism in the endoscope apparatus according tothe 42nd embodiment;

[0177]FIG. 93B is a side view of the guide wire fixing member main bodyin the endoscope apparatus according to the 42nd embodiment;

[0178]FIG. 93C is a plane view showing a back surface of the guide wirefixing mechanism portion in the endoscope apparatus according to the42nd embodiment;

[0179]FIG. 93D is a side view of the guide wire fixing mechanism portionin the endoscope apparatus according to the 42nd embodiment;

[0180]FIG. 94A is a plane view of a front surface side of the guide wirefixing member main body in the endoscope apparatus according to the 42ndembodiment;

[0181]FIG. 94B is a plane view of a back surface side of a base memberin the endoscope apparatus according to the 42nd embodiment;

[0182]FIG. 94C is a side view of the base member in the endoscopeapparatus according to the 42nd embodiment;

[0183]FIG. 95A is a plane view of a guide wire fixture in the endoscopeapparatus according to the 42nd embodiment;

[0184]FIG. 95B is a plane view of a guide wire identification member inthe endoscope apparatus according to the 42nd embodiment;

[0185]FIG. 95C is a side view of a guide wire identification member inthe endoscope apparatus according to the 42nd embodiment;

[0186]FIG. 95D is a side view of a stopper in the endoscope apparatusaccording to the 42nd embodiment;

[0187]FIG. 95E is a plane view of the stopper in the endoscope apparatusaccording to the 42nd embodiment;

[0188]FIG. 96 is a plane view of a top cover arranged on a front surfaceside of a base member of the guide wire fixing member main body in theendoscope apparatus according to the 42nd embodiment;

[0189]FIG. 97A is a side view showing an attachment member of the guidewire fixing member in the endoscope apparatus according to the 42ndembodiment;

[0190]FIG. 97B is a plane view showing an attachment member of the guidewire fixing member in the endoscope apparatus according to the 42ndembodiment;

[0191]FIG. 98A is a view showing a click pin of the click mechanism ofthe guide wire fixing member in the endoscope apparatus according to the42nd embodiment;

[0192]FIG. 98B is a view showing a click groove in the endoscopeapparatus according to the 42nd embodiment;

[0193]FIG. 99A is a plane view showing an initial state of the guidewire fixing member in the endoscope apparatus according to the 42ndembodiment;

[0194]FIG. 99B is a side view of the guide wire fixing member in theendoscope apparatus according to the 42nd embodiment;

[0195]FIG. 99C is a plane view showing the state in which a stopperreleasing portion of a guide wire identification member has pushed opena stopper member in the horizontal direction in the endoscope apparatusaccording to the 42nd embodiment;

[0196]FIG. 99D is a plane view showing the state in which the stopper isreleased and the guide wire fixture is thrusted down in the endoscopeapparatus according to the 42nd embodiment;

[0197]FIG. 100A is a plane view showing the state in which the guidesire fixture and the guide wire identification member are held in thethrusted state in the endoscope apparatus according to the 42ndembodiment;

[0198]FIG. 100B is a plane view showing the state in which a click pinreaches a second convex portion and the locked state is released;

[0199]FIG. 100C is a plane view showing the state in which the guidewire fixture in process of returning to the initial state;

[0200]FIG. 101A is a plane view of an end portion of an insertionportion showing the state before the therapeutic instrument elevatorbase is raised when raising the therapeutic instrument in the endoscopeapparatus according to the 42nd embodiment;

[0201]FIG. 101B is a vertical cross-sectional view of an end portion ofan insertion portion showing the state before the therapeutic instrumentelevator base is raised when raising the therapeutic instrument in theendoscope apparatus according to the 42nd embodiment;

[0202]FIG. 101C is a plane view of an end portion of an insertionportion showing the state in which the therapeutic instrument elevatorbase is raised and the stopper is released;

[0203]FIG. 101D is a vertical cross-sectional view of the end portion ofthe insertion portion showing the state before the therapeuticinstrument elevator base is raised when raising the therapeuticinstrument in the endoscope apparatus according to the 42nd embodiment;

[0204]FIG. 101E is a plane view of an end portion of an insertionportion showing the state in which the guide wire fixture and the guidewire identification member are thrusted down according to the 42ndembodiment;

[0205]FIG. 101F is a vertical cross-sectional view of the end portion ofthe insertion portion showing the state in which the guide wire fixtureand the guide wire identification member are thrusted down according tothe 42nd embodiment;

[0206]FIG. 102A is a plane view of the end portion of the insertionportion showing the state before the therapeutic instrument elevatorbase is raised when raising the guide wire in the endoscope apparatusaccording to the 42nd embodiment;

[0207]FIG. 102B is a vertical cross-sectional view of the end portion ofthe insertion portion showing the state before the therapeuticinstrument elevator base is raised when raising the guide wire in theendoscope apparatus according to the 42nd embodiment;

[0208]FIG. 102C is a plane view of the end portion of the insertionportion showing the state in which the guide wire is pressed against andfixed to the therapeutic instrument elevator base and the guide wirefixture in the endoscope apparatus according to the 42nd embodiment;

[0209]FIG. 102D is a vertical cross-sectional view of the end portion ofthe insertion portion showing the state before the therapeuticinstrument elevator base is raised when raising the guide wire in theendoscope apparatus according to the 42nd embodiment;

[0210]FIG. 103A is a plane view of a front surface side of a base memberin a guide wire fixing portion main body according to a 43rd embodimentof the present-invention;

[0211]FIG. 103B is a plane view of a back surface side of the basemember in the guide wire fixing member main body according to the 43rdembodiment;

[0212]FIG. 103C is a side view of the base member of the guide wirefixing member main body according to the 43rd embodiment;

[0213]FIG. 103D is a plane view of a guide wire fixture according to the43rd embodiment;

[0214]FIG. 103E is a plane view of a guide wire identification memberaccording to the 43rd embodiment;

[0215]FIG. 103F is a side view of the guide wire identification memberaccording to the 43rd embodiment;

[0216]FIG. 103G is a plane view of a stopper member according to the43rd embodiment;

[0217]FIG. 103H is a side view of the stopper member according to the43rd embodiment;

[0218]FIG. 103I is a plane view of a click pin of a click mechanismaccording to the 43rd embodiment;

[0219]FIG. 103J is a view showing a click groove of the click mechanismaccording to the 43rd embodiment;

[0220]FIG. 104A is a plane view showing the initial state before atherapeutic instrument elevator base is raised in the operation of aguide wire fixing member main body when raising a therapeutic instrumentin the endoscope apparatus according to the 43rd embodiment;

[0221]FIG. 104B is a vertical cross-sectional view showing the initialstate before the therapeutic instrument elevator base is raised in theoperation of the guide wire fixing member main body when raising thetherapeutic instrument in the endoscope apparatus according to the 43rdembodiment;

[0222]FIG. 104C is a plane view showing the state in which thetherapeutic instrument elevator base is raised and a stopper is releasedin the endoscope apparatus according to the 43rd embodiment;

[0223]FIG. 104D is a vertical cross-sectional view in the endoscopeapparatus according to the 43rd embodiment;

[0224]FIG. 104E is a plane view showing the state in which a guide wirefixture and the guide wire identification member are thrusted down inthe endoscope apparatus according to the 43rd embodiment;

[0225]FIG. 104F is a vertical cross-sectional view showing the state inwhich the guide wire fixture and the guide wire identification memberare thrusted down in the endoscope apparatus according to the 43rdembodiment;

[0226]FIG. 105A is a plane view showing the click releasing state of theguide wire fixture and the guide wire identification member in theendoscope apparatus according to the 43rd embodiment;

[0227]FIG. 105B is a vertical cross-sectional view showing the clickreleasing state of the guide wire fixture and the guide wireidentification member in the endoscope apparatus according to the 43rdembodiment;

[0228]FIG. 105C is a plane view showing the state in which the guidewire fixture and the guide wire identification member return to initialpositions in the endoscope apparatus according to the 43rd embodiment;

[0229]FIG. 105D is a vertical cross-sectional view showing the state inwhich the guide wire fixture and the guide wire identification memberreturn to the initial positions in the endoscope apparatus according tothe 43rd embodiment;

[0230]FIG. 106A is a plane view of the end portion of the insertionportion showing the state before the therapeutic instrument elevatorbase is raised in the endoscope apparatus according to the 43rdembodiment;

[0231]FIG. 106B is a vertical cross-sectional view of the end portion ofthe insertion portion showing the state before the therapeuticinstrument elevator base is raised in the endoscope apparatus accordingto the 43rd embodiment;

[0232]FIG. 106C is a plane view of the end portion of the insertionportion showing the state in which the therapeutic instrument elevatorbase is raised and the stopper is released in the endoscope apparatusaccording to the 43rd embodiment;

[0233]FIG. 106D is a vertical cross-sectional view of the end portion ofthe insertion portion showing the state in which the therapeuticinstrument elevator base is raised and the stopper is released in theendoscope apparatus according to the 43rd embodiment;

[0234]FIG. 106E is a plane view of the end portion of the insertionportion showing the state in which the guide sire fixture and the guidewire identification member are thrusted down;

[0235]FIG. 106F is a vertical cross-sectional view of the end portion ofthe insertion portion showing the state in which the guide wire fixtureand the guide wire identification member are thrusted down;

[0236]FIG. 107A is a plane view of the end portion of the insertionportion showing the state before the therapeutic instrument elevatorbase is raised when the guide wire is raised in the endoscope apparatusaccording to the 43rd embodiment;

[0237]FIG. 107B is a vertical cross-sectional view of the end portion ofthe insertion portion showing the state before the therapeuticinstrument elevator base is raised when the guide wire is raised in theendoscope apparatus according to the 43rd embodiment;

[0238]FIG. 107C is a plane view of the end portion of the insertionportion showing the state in which the guide wire is pressed against andfixed to the therapeutic instrument elevator base and the guide wirefixture;

[0239]FIG. 107D is a vertical cross-sectional view of the end portion ofthe insertion portion showing the state before the therapeuticinstrument elevator base is raised according to the 43rd embodiment;

[0240]FIG. 108A is a perspective view of a primary part showing thestate in which a gripping therapeutic instrument is inserted into anexternal channel according to a 44th embodiment of the presentinvention;

[0241]FIG. 108B is a perspective view of a primary part showing thestate in which a snare in the gripping therapeutic instrument isinserted into the external channel according to the 44th embodiment;

[0242]FIG. 108C is a perspective view of a primary part showing thestate in which a guide wire thrusting plate in the gripping therapeuticinstrument is inserted into the external channel according to the 44thembodiment;

[0243]FIG. 108D is a perspective view of a primary part showing non-slipzigzag grooves of a contact surface of an arm portion of the grippingtherapeutic instrument shown in FIG. 108A with the guide wire;

[0244]FIG. 108E is a perspective view of a primary part showing thestate in which resin such as rubber is applied to a contact surface ofthe arm portion of the gripping therapeutic instrument shown in FIG.108C with the guide wire;

[0245]FIG. 109 is a perspective view of a primary part showing theattachment state of a guide wire fixing member in an endoscope apparatusaccording to a 45th embodiment of the present invention;

[0246]FIG. 110A is a perspective view of a primary part showing thestate in which a gripping therapeutic instrument is attached to an endportion of an insertion portion in an endoscope according to a 46thembodiment of the present invention;

[0247]FIG. 110B is a perspective view of a primary part showing thestate in which a bending portion of the endoscope according to the 46thembodiment is curved to relax an operation wire;

[0248]FIG. 110C is a perspective view of a primary part showing thestate in which a guide wire is raised to a position at which it can bepinched by the gripping therapeutic instrument in the endoscopeaccording to the 46th embodiment;

[0249]FIG. 111A is a vertical cross-sectional view of a primary partshowing the set-up state of the therapeutic instrument when the guidewire fixing member is detachably attached in the vicinity of the endportion of the insertion portion of the endoscope;

[0250]FIG. 111B is a vertical cross-sectional view of a primary partshowing the state in which the guide wire is raised in place of thetherapeutic instrument shown in FIG. 111A;

[0251]FIG. 111C is a vertical cross-sectional view of a primary partshowing the set-up state of the therapeutic instrument when the guidewire fixing member is embedded in the vicinity of the end portion of theinsertion portion of the endoscope;

[0252]FIG. 111D is a vertical cross-sectional view of a primary partshowing the state in which the guide wire is raised in place of thetherapeutic instrument shown in FIG. 111A;

[0253]FIG. 112A is a plane view of a primary part showing the endportion of the insertion portion in an existing endoscope;

[0254]FIG. 112B is a side view of FIG. 112A;

[0255]FIG. 112C is a plane view of a primary part showing an endoscopewhich has a guide wire fixing member setting space at the end portion ofthe insertion portion of the endoscope;

[0256]FIG. 112D is a side view of FIG. 112C;

[0257]FIG. 112E is a plane view of a primary part showing an endoscopehaving an attachment member of a guide wire fixing mechanism portion;

[0258]FIG. 112F is a side view of FIG. 112E;

[0259]FIG. 112G is a plane view of a primary part showing an endoscopein which a guide wire fixing member having a guide wire fixing mechanismportion is undetachably included;

[0260]FIG. 112H is a side view of FIG. 112G;

[0261]FIG. 113A is a plane view of a primary part showing a modificationof a guide wire;

[0262]FIG. 113B is a plane view of a primary part showing anothermodification of the guide wire;

[0263]FIG. 113C is a plane view of a primary part showing still anothermodification of the guide wire;

[0264]FIG. 114A is an explanatory drawing for illustrating the operationstate for pulling out a catheter from a therapeutic instrument insertionchannel of an endoscope when performing endoscopic treatment by usingthe endoscope by a conventional method; and

[0265]FIG. 114B is an explanatory drawing for illustrating the operationstate for completely pulling out the catheter from the endoscope.

DETAILED DESCRIPTION OF THE INVENTION

[0266] FIGS. 1 to 6B show a first embodiment according to the presentinvention. FIG. 1 shows a schematic structure of an entire system of anendoscope apparatus in which an endoscope 1 and various kinds ofexternal devices are incorporated according to this embodiment. As theexternal devices, there are devices such as a light source device 2, animage processing device 3, a monitor 4, an input keyboard 5, a suctionpump device 6, a water supply jar 7 and others, and these devices areset in a shelf having carriers 8.

[0267] Further, to the endoscope 1 are provided an elongated insertionportion 12 which is inserted into a celoma, an operation portion 13 on afront side which is connected to a base end portion of the insertionportion 12, a universal cord 14 whose base end portion is connected tothe operation portion 13. Furthermore, to the insertion portion 12 areprovided respective constituent parts including an elongated flexiblepipe portion 15 having the flexibility, a bending portion 16 connectedto an end of the flexible pipe portion 15, and an end portion 17arranged at a leading edge position of the insertion portion 12.

[0268] Moreover, a connector 18 is provided to an end portion of theuniversal cord 14 connected to the operation portion 13. A light guidepipe or an electrical contact portion is provided to this connector 18.In addition, this connector 18 is connected to the light source device 2and the image processing device 3 as the external devices, respectively.

[0269] Additionally, as shown in FIG. 7A, a concave notch portion 17 aobtained by notching one side surface is formed on the outer peripheralsurface of the end portion 17 of the endoscope 1. Further, a channelopening portion 26 is arranged on one side portion of this notch portion17 a. Furthermore, an observation optical system object lens (not shown)and an illumination optical system illumination lens (not shown) areprovided in alignment next to the channel opening portion 26.

[0270] Moreover, an air supply/water supply nozzle (not shown) protrudeson a rear end wall surface 17 b of the notch portion 17 a of the endportion 17. In addition, a fluid such as water or air is blown from thisnozzle to the external surface of the object lens, thereby cleaning thelens surface.

[0271] In addition, to the operation portion 13 of the endoscope 1 areprovided a curving operation portion 56 for curving the bending portion16 of the insertion portion 12 in the vertical/horizontal direction, anair supply/water supply button 59, and a suction operation button 60.Also, an insertion opening portion 61 which is connected to thetherapeutic instrument insertion channel 23 is provided. Additionally,the nozzle of the end portion 17 is caused to selectively inject the gasand the liquid by the operation of the air supply/water supply button59. Further, the suction force is selectively caused to act on thechannel opening portion 26 of the end portion 17 by the operation of thesuction operation button 60 through the therapeutic instrument insertionchannel 23, thereby collecting mucin and the like in a celoma.

[0272] Furthermore, as shown in FIGS. 3 and 4, an elevator baseactuation mechanism 41 for operating the set-up wire 30 is included inthe operation portion 13. A wire fixing member 42 consisting of a hardbar-like material such as a metal is integrally fixed to a base endportion of the set-up wire 30 by solder and the like. An engagementgroove 43 made up of a concave portion is formed at a base end portionof the wire fixing member 42 as shown in FIG. 4.

[0273] Moreover, a link member 44 constituted by a hard block body suchas a metal is fixed to the base end portion of the wire fixing member42. An insertion hole 44 a of the wire fixing member 42 is formed at thelink member 44. In addition, the base end portion of the wire fixingmember 42 is fitted into the insertion hole 44 a of the link member 44.Areas of the base end portion of the wire fixing member 42 to which theengagement groove 43 is formed are all fitted in the insertion hole 44 aof the link member 44.

[0274] Additionally, a female screw portion 45 to which a fixing screw46 of the wire fixing member 42 is screwed and inserted is provided tothe link member 44. Further, an end portion of the fixing screw 46screwed to the female screw portion 45 of the link member 44 is engagedin the engagement groove 43 of the wire fixing member 42 in the insertedstate. As a result, the wire fixing member 42 is connected to the linkmember 44 in the fixed state.

[0275] Furthermore, a base 47 as a base board of the operation portion13 is provided inside the operation portion 13. Moreover, the linkmember 44 is arranged in the longitudinal direction of the base 47 so asto be capable of moving back and forth.

[0276] In addition, one end portion of an arm 49 is connected to thelink member 44 by a link shaft 50 as a bar-like shaft member so as to becapable of swiveling. An engagement member 51 consisting of a C type orE type snap ring and the like is engaged with an end portion which is onthe opposite side to the end portion of the base 47 side in the linkshaft 50.

[0277] Further, the other end portion of the arm 49 is connected to anelevator operation knob 48 which is provided in contiguity with thecurving operation portion 56. Furthermore, a set-up wire 30 is pulled bythe operation of the elevator operation knob 48 in the operation portion13 through the arm 49, the link member 44 and the wire fixing member 42in sequence, and derricking motion of the therapeutic instrumentelevator base 27 is caused around an elevator base swivel supportingpoint. As a result, a guide catheter and a guide wire 68 which areinserted into the therapeutic instrument insertion channel 23 and led tothe outside from the channel opening portion 26 are raised by raisingthe therapeutic instrument elevator base 27.

[0278] The structure of the end portion 17 of the insertion portion 12will now be described in detail with reference to FIG. 2. An end hardportion 21 as an end portion main body and an end cover 22 which isformed of a non-conductive material such as resin so as to surround theend hard portion 21 are provided to the end portion 17. The end cover 22is fixed to the end hard portion 21 by an adhesive and the like.

[0279] Further, a lead-in guide path 24 for guiding leading of atherapeutic instrument and the like to the end side is formed at the endhard portion 21. This lead-in guide path 24 is formed so as to beconnected with the therapeutic instrument insertion channel (insertionhole) 23 as a therapeutic instrument insertion guide path provided inthe insertion portion 12 of the endoscope 1.

[0280] Furthermore, to the end side of the lead-in guide path 24 isprovided an accommodation chamber 25 as a space portion formed by theend hard portion 21 and the end cover 22. Moreover, a channel openingportion 26 constituting the end opening portion of the therapeuticinstrument insertion channel 23 is formed by the opening portion of theaccommodation chamber 25.

[0281] Moreover, a therapeutic instrument elevator base 27 for raising,e.g., a therapeutic instrument led through the channel 23 or atherapeutic instrument such as a guide catheter to a desired position isprovided in the accommodation chamber 25. One end of the therapeuticinstrument elevator base 27 is pivoted by an elevator base swivelsupporting point 28 provided to the end hard portion 21.

[0282] The elevator base swivel supporting point 28 is arranged at alower part of the end opening portion of the lead-in guide path 24. Inaddition, the therapeutic instrument elevator base 27 is attached in theaccommodation chamber 25 with the elevator base swivel supporting pointat the center so as to be capable of a derricking motion so that thetherapeutic instrument elevator base 27 can swivel from a standbyposition indicated by solid lines shown in FIG. 2 to a therapeuticinstrument set-up position indicated by dotted lines in the samedrawing.

[0283] In addition, a guide plane 29 for guiding, e.g., a therapeuticinstrument or that such as a guide catheter is formed on the therapeuticinstrument elevator base 27. This guide plane 29 has a cross-sectionalshape which is continuous from the lead-in guide path 24 being formed bya substantially-V-shaped groove.

[0284] Additionally, an end portion of a set-up wire 30 is fixed to thetherapeutic instrument elevator base 27. This set-up wire 30 is led tothe operation portion 13 side through a guide pipe 31 and a guide tube32 inserted into the insertion portion 12, and connected to alater-described elevator base operation mechanism 41. Further, thetherapeutic instrument elevator base 27 is configured to perform thederricking motion with the elevator base swivel supporting point 28 atthe center by the towing operation of the set-up wire 30.

[0285] Furthermore, as shown in FIG. 6B, a wire engagement groove 321having a slit-like shape is provided as guide wire fixing means on thebottom of the substantially-V-shaped groove in the guide plane 29 of thetherapeutic instrument elevator base. This wire engagement groove 321has two opposed wall surfaces and a width such that only the outerperiphery of the guide wire 68 is brought into contact with the walls.Moreover, the guide wire 68 is releasably engaged with the wireengagement groove in the inserted state.

[0286] Incidentally, as the wire engagement groove 321, a grove whosewidth is narrowed in the tapered shape toward the bottom and which has asubstantially-V-shaped cross section is preferable. In addition, it isalso good that the relationship between an opening portion slit width(groove width) T1 of the wire engagement groove 321, a wire diameter D1of the guide wire 68 and an outside diameter D2 of the therapeuticinstrument or any other therapeutic instrument such as a catheter is setto “D1<T1<D2”.

[0287] The effect of this embodiment will now be described. When theendoscope 1 according to this embodiment is used, a guide catheter isinserted into the therapeutic instrument insertion channel 23 from theinsertion opening portion 61 of the operation portion 13 of theendoscope 1. Additionally, the guide catheter is caused to protrude fromthe channel opening portion 26 to the outer side and inserted into apancreatic/hepatic duct (not shown) in the papillotomy manner.Thereafter, the currently used guide catheter is replaced with atherapeutic instrument which is subsequently used.

[0288] In the operation for replacing the therapeutic instrument, theguide wire 68 is first inserted from a mouth ring of the guide catheteron the base end side. Insertion of the end portion of the guide wire 68into the pancreatic/hepatic duct is confirmed by an observation image(endoscopic image) of the endoscope 1, and the base end side of theguide wire 68 is gripped by hand.

[0289] Subsequently, in this state, the operation for pulling out theguide catheter is performed, and an observation image is used to confirmthat the guide catheter has been pulled out from the papilla.Thereafter, the catheter is further pulled out toward the front side.Further, with the end of the guide catheter being accommodated in thechannel opening portion 26, an elevator operation knob 48 of thetherapeutic instrument elevator base 27 is operated. With the operationof the elevator operation knob 48, the set-up wire 30 is operated andtowed, and the therapeutic instrument elevator base 27 is caused toswivel around the elevator base swivel supporting point 28 and raised asindicated by the dotted lines shown in FIG. 5.

[0290] Furthermore, when raising the therapeutic instrument elevatorbase 27 as shown in FIG. 6A, the guide wire 68 is led into the wireengagement groove 321 along the substantially-V-shaped groove in theguide plane 29 of the therapeutic instrument elevator base 27 as shownin FIG. 6B. Then, the guide wire 68 is releasably engaged while beinginserted in the wire engagement groove 321. At this moment, the guidewire 68 is pressed against an upper surface 273 side of the lead-inguide path 24 of the end hard portion 21 by the therapeutic instrumentelevator base 27 as indicated by an arrow P in FIG. 6A. At this moment,since the reaction force indicated by an arrow Fr in FIG. 6A acts fromthe hard guide wire 68 so as to maintain the linear shape, this reactionforce causes the guide wire 68 to be strongly engaged by being pushedinto the wire engagement groove 321. As a result, the guide wire 68 ismechanically fixed to the end portion 17 of the insertion portion 12 inthis state.

[0291] Moreover, after an observation image of the endoscope 1 is usedto confirm that the guide wire 68 has been fixed, the guide catheter iscompletely pulled out from the operation portion 13 side of theendoscope 1 to the outside of the therapeutic instrument insertionchannel 23.

[0292] Thereafter, a therapeutic instrument which is subsequently usedis inserted from the base end side of the guide wire 68. At this moment,with the guide wire 68 being used as a guide, the therapeutic instrumentis inserted into the therapeutic instrument insertion channel 23. Then,when the end of the therapeutic instrument is brought into contact withthe therapeutic instrument elevator base 27, the therapeutic instrumentelevator base 27 is lowered by the operation of the elevator operationknob 48. As a result, when the therapeutic instrument passes thevicinity of the therapeutic instrument elevator base 27, the thrustingforce of the therapeutic instrument at this moment pushes out the guidewire 68 from the wire engagement groove 321, thereby releasing fixationof the guide wire 68. In addition, the therapeutic instrument isinserted into a pancreatic/hepatic duct.

[0293] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the guide wire 68 can be readily fixed bythe regularly performed operation for raising the therapeutic instrumentelevator base 27, namely, operating the elevator operation knob 48 ofthe operation portion 13 on the front side in the endoscope 1.

[0294] Additionally, in this embodiment, since conventional therapeuticinstruments can be used as they are, the excellent operability can bemaintained without being deteriorated by using the therapeuticinstrument that an operator is used to dealing with. Therefore, thetherapeutic instrument can be easily replaced in a shorter time withoutimpairing the conventional operation method of the therapeuticinstrument or the operation style.

[0295] Further, since the guide wire 68 can be fixed at the end portion17 of the insertion portion 12 of the endoscope 1, the length of theguide wire 68 can be shortened. Therefore, rolling of the guide wire 68can be facilitated, and a large operation space is no longer necessary.Furthermore, replacement of the therapeutic instrument can befacilitated, and the number of assistants can be decreased, whichresults in reduction in the operation time.

[0296] Moreover, by forming the wire engagement groove 321 into asubstantially V shape, the guide wire 68 whose outside diameter subtlydiffers can be stably and strongly engaged with the wire engagementgroove 321. In addition, by providing the wire engagement groove 321 tothe therapeutic instrument elevator base 27, the guide wire 68 led tothe guide plane 29 is constantly placed in the same wire engagementgroove 321. Therefore, at the time of the operation for fixing the guidewire 68, the fixed state of the guide wire 68 is constantly stabled eachand every time, and irregularities in the fixing strength caused due toa position of the guide wire 68 can be eliminated.

[0297] Additionally, in this embodiment, the relationship between theslit width (groove width) T1 of the wire engagement groove 321, the wirediameter D1 of the guide wire 68 and the outside diameter D2 of thetherapeutic instrument or any other counterpart such as the catheter 67is set to “D1≦T1<D2”. Therefore, as indicated by a dotted line in FIG.6B, the therapeutic instrument which is usually used, for example, thetube-like catheter 67 fitted on the guide wire 68 can be successfullyused without being caught in the wire engagement groove 321.

[0298] Further, FIGS. 7A to 7C show a second embodiment according to thepresent invention. In this embodiment, the structure of the end portion17 of the insertion portion 12 in the endoscope 1 according to the firstembodiment is modified as follows.

[0299] That is, in this embodiment, a slit-like wire engagement groove331 corresponding to the wire engagement groove 321 of the therapeuticinstrument elevator base 27 for fixing the guide wire 68 in the firstembodiment is provided on the upper surface 273 side of the lead-inguide path 24 of the end hard portion 21. The relationship between theopening portion slit width (groove width) T1 of the wire engagementgroove 331, the wire diameter D1 of the guide wire 68 and the outsidediameter D2 of the therapeutic instrument or any other therapeuticinstrument such as the guide catheter is set to “D1≦T1<D2” as in thefirst embodiment.

[0300] The effect of this embodiment will now be described. When theendoscope 1 according to this embodiment is used, as in the firstembodiment, after the guide catheter and the guide wire 68 are insertedinto the body through the channel 23, the elevator operation knob 48 ofthe therapeutic instrument elevator base 27 is operated with the guidecatheter being pulled into the introduction guide path 24 or the channel23. With the operation of the elevator operation knob 48, the set-upwire 30 is operated to be towed, and the therapeutic instrument elevatorbase 27 is caused to swivel around the elevator base swivel supportingpoint 28 and raised as indicated by dotted lines in FIG. 7C.

[0301] Furthermore, when raising the therapeutic instrument elevatorbase 27, the guide wire 68 is pressed against the upper surface 273 sideof the lead-in guide path 24 of the end hard portion 21 by thetherapeutic instrument elevator base 27 as shown in FIG. 7C.

[0302] At this moment, since the reaction force acts from the hard guidewire 68 so as to maintain the linearity, the guide wire 68 is stronglyengaged in the wire engagement groove 331 of the end hard portion 21 bythis reaction force. Therefore, as shown in FIG. 7A, the guide wire 68is mechanically fixed to the end portion 17 of the insertion portion 12in this state.

[0303] Moreover, after confirming that the guide wire 68 has been fixed,the guide catheter is completely pulled out from the operation portion13 side of the endoscope 1 to the outside of the therapeutic instrumentinsertion channel 23.

[0304] Then, a therapeutic instrument which is subsequently used isinserted from the base end side of the guide wire 68. At this moment,with the guide wire 68 being used as a guide, the therapeutic instrumentis inserted into the treatment insertion channel 23. Then, when the endof the therapeutic instrument is brought into contact with thetherapeutic instrument elevator base 27, the therapeutic instrumentelevator base 27 is lowered by the operation of the elevator operationknob 48. When the therapeutic instrument passes the vicinity of thetherapeutic instrument elevator base 27 in this state, the guide wire 68is pushed out from the wire engagement groove 331 by the thrusting forceof the therapeutic instrument at this moment, thereby releasing fixationof the guide wire 68.

[0305] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the guide wire 68 can be readily fixed byonly the operation for raising the therapeutic instrument elevator base27 which is usually carried out on the front operation portion 13 sidein the endoscope 1. Thus, the advantage similar to that in the firstembodiment can be also obtained in this embodiment.

[0306] Moreover, in this embodiment, since the relationship between theopening portion slit width (groove width) T1 of the wire engagementgroove 331, the wire diameter D1 of the guide wire 68, and the outsidediameter D2 of the therapeutic instrument or any other therapeuticinstrument such as the guide catheter is set to “D1≦T1<D2”, theregularly used therapeutic instrument can be successfully used withoutbeing caught in the wire engagement groove 331.

[0307] As a modification of the first and second embodiments, it ispossible to provide both the wire engagement grove 331 provided on theupper surface 273 side of the lead-in guide path 24 of the end hardportion 21 described in connection with the second embodiment and thewire engagement groove 321 provided on the guide plane 29 of thetherapeutic instrument elevator base 27 described in connection with thefirst embodiment, as shown in FIG. 7D.

[0308] The effect obtained by this modification is that, as in the firstand second embodiments, the guide wire 68 enters the respective wireengagement grooves 321 and 331 and is engaged at the two points byraising the therapeutic instrument elevator base 27.

[0309] The advantage obtained by this modification lies in thatengagement at the two points increases the fixation strength in additionto the advantage similar to that in the above-described first and secondembodiments.

[0310] Moreover, FIGS. 8A and 8B show a third embodiment. In thisembodiment, the structure of the end portion 17 of the insertion portion12 in the endoscope 1 according to the first embodiment is modified asfollows.

[0311] That is, in this embodiment, as shown in FIGS. 8A and 8B, aslit-like wire engagement groove 321 for releasably engaging the guidewire 68 is provided on the bottom of the substantially-V-shaped groovein the guide plane 29 of the therapeutic instrument elevator base 27.Here, as shown in FIG. 8A, the central axis of the wire engagementgroove 321 is determined as M1, and the central axis of the guide plane29 is determined as M2. In this state, by inclining the part between M1and M2 by θ, an angle of the wire engagement groove 321 can be inclinedby θ.

[0312] It is to be noted that with respect to M1 this inclination θ maybe given to either the object lens side or the opposite side to theobject lens with M1 therebetween.

[0313] Further, the wire engagement groove 321 does not have to beprovided at an intersection between the central axis M1 of the wireengagement groove 321 and the central axis M2 of the guide plane 29. Forexample, as shown in FIG. 8C, the wire engagement groove 321 may beprovided at a position deviating from the center of the guide plane 29as shown in FIG. 8C.

[0314] In this embodiment, when raising the therapeutic instrumentelevator base 27, the guide wire 68 is led into the wire engagementgroove 321 obliquely provided with respect to the insertion portionaxial direction along the guide plane 29 by the therapeutic instrumentelevator base 27, and fitted in the wire engagement groove 321 as shownin FIG. 8B, thereby being releasably engaged. The effect obtainedthereafter is similar to that of the first embodiment mentioned above.

[0315] Furthermore, FIG. 9 shows a fourth embodiment according to thepresent invention. In this embodiment, the structure of the therapeuticinstrument elevator base 27 according to the first embodiment ismodified as follows.

[0316] That is, in this embodiment, there is formed a surface finishedplane 541 having the large friction resistance which has been subjectedto surface finishing by which minute irregularities are formed toroughen the inner surface of the wire engagement groove 321 in thetherapeutic instrument elevator base 27 according to the firstembodiment. This surface finished plane 541 is formed by, for example,surface finishing for causing the chemical reaction such as corrosion onthe inner surface of the wire engagement groove 321 or any otherfinishing for embedding or attaching a member having the large frictionresistance, e.g., rubber, silicon or any other elastomer.

[0317] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the advantage similar to that in the firstembodiment can be obtained, and the friction resistance between theguide wire 68 and the wire engagement groove 321 is increased by thesurface finished plane 541 of the inner surface of the wire engagementgroove 321 in the therapeutic instrument elevator base 27, therebyincreasing a quantity of fixing power for the guide wire 68.

[0318] Furthermore, FIGS. 10A and 10B show a fifth embodiment accordingto the present invention. In this embodiment, the structure of thetherapeutic instrument elevator base 27 of the endoscope 1 in the firstembodiment is changed as follows.

[0319] That is, in the therapeutic instrument elevator base 27 of thisembodiment, there is provided a chamfered portion 551 obtained bychamfering the entire edge line between the wire engagement groove 321and the guide plane 521.

[0320] The following advantage can be obtained in this embodiment. Thatis, the advantage similar to that in the first embodiment can beobtained in this embodiment. In addition to this, when the therapeuticinstrument elevator base 27 is raised, the guide wire 68 is guided alongthe chamfered portion 551 and can thereby readily enter the wireengagement groove 321. Moreover, when inserting the guide wire 68 or anyother therapeutic instrument, it is advantageously possible to eliminatedamages to the edge portion of the wire engagement groove 321 which aregiven when the guide wire 68 or any other therapeutic instrument arecaught at this edge portion according to the present invention.

[0321] In addition, FIGS. 11A and 11B show a sixth embodiment. In thisembodiment, the structure of the therapeutic instrument elevator base 27of the endoscope 1 in the first embodiment is changed as follows.

[0322] That is, in this embodiment, engagement protrusions 502 fornarrowing the width of the opening end portion of the wire engagementgroove 321 are provided at the upper portions of the wall surfaces 501on the both sides in the wire engagement groove 321 of the therapeuticinstrument elevator base 27 A distance between the engagementprotrusions 502 on the both sides at the opening end portion of the wireengagement groove 321 is set so as to be a gap which is slightlynarrower than the outside diameter dimension of the guide wire 68.

[0323] The effect of this embodiment will now be described. In thisembodiment, as in the therapeutic instrument elevator base 27 of theendoscope 1 according to the first embodiment, with the guide catheterbeing pulled into the therapeutic instrument insertion channel 23, theguide wire 68 is led to the wire engagement groove 321 by the guideplane 29 of the therapeutic instrument elevator base 27 by raising thetherapeutic instrument elevator base 27.

[0324] At this moment, as a swiveling angle of the therapeuticinstrument elevator base 27 increases with the swiveling operation ofthe therapeutic instrument elevator base 27, the guide wire 68 isstrongly pushed by the protrusions 502 from the outside, and the guidewire 68 starts to be elastically deformed. Then, with an appropriateangle before the swiveling angle of the therapeutic instrument elevatorbase 27 reaches a maximum set-up angle, the guide wire 68 gets over theprotrusions 502, and the guide wire 68 is fitted in the wire engagementgroove 321 as shown in FIG. 11B. As a result, the guide wire 68 is fixedwhile being in contact with four points, i.e., the wall surfaces 501 onthe both sides and the engagement protrusions 502 on the both sides inthe wire engagement groove 321 of the therapeutic instrument elevatorbase 27.

[0325] Thereafter, the guide catheter is pulled out at a blast, and anyother therapeutic instrument is inserted with the guide wire 68 as aguide. At this moment, when the inserted therapeutic instrument passesalong the wire engagement groove 321, the guide wire 68 is pushed outfrom the wire engagement groove 321 by the thrusting force of thetherapeutic instrument, and fixation of the guide wire 68 is released.

[0326] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, as in the endoscope 1 of the firstembodiment, the guide wire 68 can be easily fixed by only the usuallyperformed operation for raising the therapeutic instrument elevator base27 by which the elevator operation knob 48 of the front operationportion 13 in the endoscope 1 is operated.

[0327] Also, in this embodiment, in addition to the advantage similar tothat of the endoscope 1 according to the first embodiment, in the caseof fixing the guide wire 68, when the guide wire 68 gets over theengagement protrusions 502 on the both sides of the opening end portionin the wire engagement groove 321 from the outside, the guide wire 68can be further strongly fixed by sandwiching the guide wire 68 by thewire engagement groove 321 and the engagement protrusions 502 on theboth sides.

[0328] Additionally, when fixing the guide wire 68, the force of theguide wire 68 to move in the upper surface direction of the therapeuticinstrument elevator base 27 can be suppressed by the engagementprotrusions 502 on the both sides.

[0329] Further, as in the first modification of the therapeuticinstrument elevator base 27 in the sixth embodiment shown in FIG. 12A,the engagement protrusions 502 on the both sides of the opening endportion in the wire engagement groove 321 of the therapeutic instrumentelevator base 27 may be provided in the entire area of the wireengagement groove 321 or a part of the wire engagement groove 321 alongthe insertion portion axial direction. Furthermore, as in the secondmodification of the therapeutic instrument elevator base 27 in the sixthembodiment shown in FIG. 12B, a plurality of engagement protrusions 502may be provided on the both sides of the opening end portion in the wireengagement groove 321 of the therapeutic instrument elevator base 27.

[0330] Furthermore, as in the third modification of the therapeuticinstrument elevator base 27 in the sixth embodiment shown in FIG. 12C,the engagement protrusion 502 may be provided on only one side of theopening end portion in the wire engagement groove 321 of the therapeuticinstrument elevator base 27 so as not to extremely lower the fixingcapability for the guide wire 68. When the engagement protrusion 502 isprovided on only one surface of the opening end portion in the wireengagement groove 321 of the therapeutic instrument elevator base 27 inthis manner, since the quantity of the operation force at the time ofinserting/removing the guide wire 68 into/from the wire engagementgroove 321 is reduced, the fixing operation of the guide wire 68 canbecome advantageously relatively easy.

[0331] Moreover, FIGS. 13 to 15B show a seventh embodiment according tothe present invention. In this embodiment, the structure of thetherapeutic instrument elevator base 27 of the endoscope 1 according tothe first embodiment is modified as follows.

[0332] That is, in this embodiment, the wire engagement groove 321 ofthe therapeutic instrument elevator base 27 is provided at a position atwhich any other therapeutic instrument doesn't come into contact withthe wire engagement groove 321 when the therapeutic instrument movesin/out with the therapeutic instrument elevator base 27 being lowered asshown in FIG. 13. FIG. 13 is a cross-sectional view when the therapeuticinstrument elevator base 27 is lowered with the guide catheter 267 beinginserted, and FIG. 14 is a cross-sectional view when the therapeuticinstrument elevator base 27 is raised. Further, the wire engagementgroove 321 of the therapeutic instrument elevator base 27 is constitutedby the guide plane 521, an end plane 522 and a connection plane 523connecting these planes.

[0333] Moreover, FIG. 15A is a front view of the therapeutic instrumentelevator base 27, and FIG. 15B is a rear view of the therapeuticinstrument elevator base 27. In this embodiment, as shown in FIGS. 15Aand 15B, the wire engagement groove 321 of the therapeutic instrumentelevator base 27 is arranged at a position which cannot seen from thefront side. In addition, the wire engagement groove 321 of thetherapeutic instrument elevator base 27 is formed so as to be graduallydeep from the connection plane 523 toward the end plane 522. As aresult, it is set in such a manner that the wire engagement groove 321is exposed to a traveling position of the guide wire 68 as thetherapeutic instrument elevator base 27 is raised.

[0334] The effect of this embodiment will now be described. In thisembodiment, as in the first embodiment, with the guide catheter 267being pulled into the therapeutic instrument insertion channel 23, thewire engagement groove 321 appears by raising the therapeutic instrumentelevator base 27, and the guide wire 68 is pinched and fixed. Any otherprocess is similar to that in the first embodiment.

[0335] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, as in the first embodiment, the guide wire68 can be easily fixed by only the usually performed operation forraising the therapeutic instrument elevator base 27 by which theelevator operation knob 48 of the front operation portion 13 of theendoscope 1 is operated.

[0336] Moreover, in this embodiment, in addition to the advantagesimilar to that of the endoscope 1 according to the first embodiment,since the wire engagement groove 321 doesn't appear on the guide plane521 when the therapeutic instrument elevator base 27 is lowered, thetherapeutic instrument cannot be damaged, and the therapeutic instrumentcan smoothly move in/out.

[0337] In addition, FIGS. 16 to 18 show an eighth embodiment accordingto the present invention. In this embodiment, the structure of thetherapeutic instrument elevator base 27 of the endoscope 1 in the firstembodiment is changed as follows.

[0338] That is, although it is desirable to design the wire engagementgroove 321 of the therapeutic instrument elevator base 27 to catch theguide wire 68 on the entire surface of the wire engagement groove 321 asshown in FIG. 17 when the guide wire 68 is raised, a certain quantity ofdisplacement is actually generally generated on the contact surfacebetween the wire engagement groove 321 and the guide wire 68 in therelationship of the machining accuracy as shown in FIG. 18. For example,when the guide wire 68 is raised by the therapeutic instrument elevatorbase 27, it is ideal that the entire bottom portion of the wireengagement groove 321 is in contact with the guide wire 68 as shown inFIG. 17. An angle between an insertion portion axis (central line) O andthe bottom portion (contact surface with the guide wire 68) of the wireengagement groove 321 at this moment is determined as θ.

[0339] In addition, in the relationship of the machining accuracy of thetherapeutic instrument elevator base 27, the displacement may begenerated in the contact surface between the wire engagement groove 321and the guide wire 68. Assuming that an angle between the insertionportion axis O and the bottom portion of the wire engagement groove 321is θ2 when this displacement is produced, the relationship of “θ<θ2” maybe attained. In this case, since the end portion of the guide wire 68 isheld down by the end portion of the wire engagement groove 321, adistance L2 between two points, i.e., the guide wire contact point ofthe therapeutic instrument elevator base 27 holding down the guide wire68 and the guide wire contact point of the lead-in guide path 24 in theend hard portion 21 is relatively long. Therefore, in this state, thereis a problem that the fixing strength for the guide wire 68 is lowered.

[0340] In this embodiment, taking a tolerance obtained by finishing thewire engagement groove 321 of the therapeutic instrument elevator base27 into consideration, when the guide wire 68 is raised by thetherapeutic instrument elevator base 27 as shown in FIG. 16, the angleθ1 between the insertion portion axis O and the wire engagement groove321 of the therapeutic instrument elevator base 27 is set with respectto the angle θ between the insertion portion axis O and the wireengagement groove 321 in the ideal stage shown in FIG. 17 so that “θ>θ1”can be achieved. As a result, when the guide wire 68 is raised by thetherapeutic instrument elevator base 27, the front side of the wireengagement groove 321 of the therapeutic instrument elevator base 27 canbe set higher than an ideal position of the end portion of the wireengagement groove 321 on the front side shown in FIG. 17, and thecontact point with the guide wire 68 is arranged on the front side ofthe wire engagement groove 321. Additionally, in this case, since thedistance L1 between two points, i.e., the guide wire contact point ofthe therapeutic instrument elevator base 27 holding down the guide wire68 and the guide wire contact point of the lead-in guide path 24 in theend hard portion 21 becomes smaller than L2 shown in FIG. 18 (L1<L2),the fixing strength for the guide wire 68 can be increased as comparedwith the case illustrated in FIG. 18.

[0341] Therefore, since a distance between two points, i.e., the wireengagement groove 321 of the therapeutic instrument elevator base 27 andthe guide wire contact point of the lead-in guide path 24 in the endhard portion 21 does not become long due to irregularities in theworking process when the guide wire 68 is raised by the therapeuticinstrument elevator base 27 in this embodiment, the fixing strength forthe guide wire 68 is not lowered by irregularities in machining the wireengagement groove 321 of the therapeutic instrument elevator base 27,and there is the advantage that the fixing strength of the guide wire 68can be stably maintained.

[0342] Further, FIGS. 19 and 20 show a ninth embodiment according to thepresent invention. In this embodiment, the structure of the therapeuticinstrument elevator base 27 according to the first embodiment is changedas follows.

[0343] That is, in this embodiment, as shown in FIG. 19, the wireengagement groove 321 for strongly bending the set-up position of theguide wire 68 which is raised by the therapeutic instrument elevatorbase 27 toward the front side away from the position of the elevatorbase swivel supporting point 28 when the therapeutic instrument elevatorbase 27 is raised at the maximum set-up level is provided at the endportion of the therapeutic instrument elevator base 27. This wireengagement groove 321 is arranged at a part in the vicinity of the endof the guide wire 68 of the therapeutic instrument elevator base 27 inthe guide plane 29. Further, when the therapeutic instrument elevatorbase 27 is raised at the maximum set-up level, the wire engagementgroove 321 is arranged at a position where it protrudes by anappropriate distance L1 toward the front side away from the position ofthe elevator base swivel supporting point 28.

[0344] It is to be noted that the clearance between the wire engagementgroove 321 provided to the therapeutic instrument elevator base 27 andthe upper surface 273 of the lead-in guide path 24 when the therapeuticinstrument elevator base 27 is raised is assured as in the prior art andmaintained so as not to interfere insertion and removal of the guidecatheter or any other therapeutic instrument.

[0345] Furthermore, a notch portion 463 obtained by scraping off a partopposed to the set-up angle stopper 462 at the end of the end hardportion 2 so as not to come into contact with the set-up angle stopper462 is formed on a side wall surface 27 a on the guide plane side of thetherapeutic instrument elevator base 27 in such a manner that theinsertion/removal property of the therapeutic instrument is notinterfered when the therapeutic instrument elevator base 27 is raised-atthe maximum level.

[0346] Incidentally, the present invention is not restricted to theabove-described structure as long as it is the structure capable ofmaintaining the positional relationship between the wire engagementgroove 321 and the elevator base swivel supporting point 28.

[0347] On the contrary, FIG. 20 is a cross-sectional view of the endportion of the endoscope with the conventional guide wire 68 beingfixed. As shown in FIG. 20, the position at which the guide wire 68 isfixed in the wire engagement groove 321 when the therapeutic instrumentelevator base 27 is raised to the maximum set-up position is arranged onthe end side away from the elevator base-swivel supporting point 28 byapproximately an appropriate distance L2.

[0348] The effect of this embodiment will now be described. In thisembodiment, as in the first embodiment, with the guide catheter beingpulled into the therapeutic instrument insertion channel 23, thetherapeutic instrument elevator base 27 is raised. At this moment, sincethe therapeutic instrument elevator base 27 is raised beyond theconventional maximum set-up angle position, the guide wire 68 can befurther bent. Therefore, the shear force between the wire engagementgroove 321 and the upper surface 273 of the lead-in guide path 24 andthe reaction force of the guide wire 68 further strongly act, and theguide wire 68 can be hence securely fixed in this state.

[0349] After confirming that the guide wire 68 is firmly fixed, theguide catheter is pulled out and another therapeutic instrument isinserted over the guide wire 68. Consequently, at this moment, thetherapeutic instrument to be inserted sets down the therapeuticinstrument elevator base 27 when passing along the wire engagementgroove 321, and the guide wire 68 is pushed out from the wire engagementgroove 321 by the thrusting force of this therapeutic instrument, andfixation between the guide wire 68 and the wire engagement groove 321 isreleased.

[0350] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the advantage similar to the firstembodiment can be obtained. In addition to this, there is an advantagethat the guide wire 68 can be further firmly fixed.

[0351] Incidentally, the above-described guide wire fixing means is notrestricted to one having the wire engagement groove 321, and only thetherapeutic instrument elevator base 27 may also function as this guidewire fixing means in order to bring in the set-up angle.

[0352] Further, FIG. 21 and FIGS. 22A to 22D show a 10th embodimentaccording to the present invention. In this embodiment, the elevatorbase actuation mechanism 401 configured as shown in FIGS. 21 and 22A isprovided in place of the elevator base actuation mechanism 41 providedinside the operation portion 13 of the endoscope 1 according to thefirst embodiment.

[0353] A elevator base operation knob 402 is provided at the end edgeportion of the operation portion 13 of the endoscope 1. To this elevatorbase operation knob 402 are provided an operation lever 403 and a fingerapplication portion 405 which is fixed to the outer end portion of theoperation lever 403 by the set screw as shown in FIG. 22A.

[0354] Furthermore, a fixing cylindrical body 406 for attaching theelevator base operation knob 402 is provided to the operation portion 13of the endoscope 1 so as to protrude therefrom. A base end portion ofthe fixing cylindrical body 406 is fixed to a non-illustrated fixingframe provided in an operation portion casing 13 a of the operationportion 13.

[0355] Moreover, a rotating ring 407 is rotatably fitted in the fixingcylindrical body 406.

[0356] It is to be noted that a bearing portion 13 b for rotatablysupporting the rotating ring 407 is provided to the operation portioncasing 13 a.

[0357] In addition, as shown in FIG. 21, a ring-like connection ring 403a is provided to the inner end portion of the operation lever 403. Thisconnection ring 403 a is screwed and fixed to the outer surface of therotating ring 407 by a plurality of set screws 408. Additionally, theelevator base operation knob 402 has the operation lever 403 beingrotatably supported along the central axis of the fixing cylindricalbody 406.

[0358] Further, a base end portion of a second link member 409 is fixedto the inner surface of the rotating ring 407. A substantially-L-shapedlink arm 409 a is provided to the second link member 409 so as toprotrude therefrom. The other end portion of the arm 49 in the elevatorbase actuation mechanism 41 according to the first embodiment isconnected to the end portion of the link arm 409 a through a second linkshaft 410 as a bar-like shaft member so as to be capable of swiveling.An engagement member 411 consisting of a C type or E type snap ring isengaged with the end portion on the opposite side to the end portion onthe arm 49 side in the second link shaft 410.

[0359] Furthermore, by rotating the operation lever 403 with the fingerapplication portion 405 as a supporting point in the swiveling operationof the elevator base operation knob 402 in the operation portion 13, thesecond link member 409 is operated to swivel through the rotating ring407, and the link member 44 is driven to move forward/backward along theaxial direction of the set-up wire 30 through the arm 49 with theswiveling operation of the second link member 409. As a result, theset-up wire 30 is towed, and the therapeutic instrument elevator base 27is caused to perform the derricking motion with the elevator base swivelsupporting point 28 at the center. Consequently, the therapeuticinstrument such as the guide catheter which is inserted into thetherapeutic instrument insertion channel 23 and led to the outside fromthe channel opening portion 26 is raised by raising the therapeuticinstrument elevator base 27.

[0360] Moreover, a braking mechanism 412 for restraining the swiveloperation force of the operation lever 403 of the elevator baseoperation knob 402 is incorporated in the elevator base actuationmechanism 401 according to this embodiment. As shown in FIG. 22B, to thebraking mechanism 412 are provided a deterrent body 413 such as a pinwhich protrudes in the middle of the operation lever 403 of the elevatorbase operation knob 402 and a deterrence reinforcement member 414 whichis arranged at a position engaged with the deterrent body 413 and shownin FIG. 22C.

[0361] In addition, to the deterrence reinforcement member 414 is formeda guide groove 414 a to which the deterrent body 413 of the operationlever 403 is inserted and which has a substantially-U-shaped crosssection as shown in FIGS. 22C and 22D. This guide groove 414 a isextended along the swivel trajectory of the deterrent body 413 in theswiveling operation of the operation lever 403. Additionally, thedeterrent body 413 is configured to pass inside the guide groove 414 aof the deterrence reinforcement member 414.

[0362] Further, a friction resistance member 415 having a large frictionresistance is embedded in the guide groove 414 a of the deterrencereinforcement member 414 on one end side of the guide groove 414 a. Thisfriction resistance member 415 is arranged in an area through which thedeterrent body 413 passes in a range L in which swivel of the operationlever 403 should be restrained in the swiveling operation of theoperation lever 403 when rotating in that range.

[0363] The effect of this embodiment will now be described. In thisembodiment, as in the endoscope 1 according to a 29th embodiment, theoperation lever 403 of the elevator base operation knob 402 of theoperation portion 13 is rotated in the operation for raising thetherapeutic instrument elevator base 27. At this moment, when theoperation lever 403 is rotated to the deterrence range L, the deterrentbody 413 comes into contact with the friction resistance member 415 inthe guide groove 414 a of the deterrence reinforcement member 414. As aresult, the load is applied to the swiveling operation of the operationlever 403, and brake is put on the swiveling operation of the operationlever 403 and this lever is fixed. Therefore, with the therapeuticinstrument elevator base 27 being swiveled to the set-up positionindicated by dotted lines in FIG. 57A, the therapeutic instrumentelevator base 27 can be fixed. Thus, the guide wire 68 led to theoutside from the channel opening portion 26 is sandwiched between theend surface of the lead-in guide path 24 of the end hard portion 21 andthe therapeutic instrument elevator base 27 and mechanically fixed.

[0364] As described above, after confirming that the guide wire 68 hasbeen fixed, the guide catheter is completely pulled out to the outsideof the therapeutic instrument insertion channel 23 from the operationportion 13 side of the endoscope 1.

[0365] Thereafter, a therapeutic instrument which is subsequently usedis inserted from the base end side of the guide wire 68. At this moment,with the guide wire 68 being used as a guide, the therapeutic instrumentis inserted into the therapeutic instrument insertion channel 23. Then,when the therapeutic instrument hustles against the therapeuticinstrument elevator base 27, the operation lever 403 of the elevatorbase operation knob 402 is returned to its original position. At thismoment, the operation lever 403 exceeds the deterrence range L, and thedeterrent body 413 comes off the friction resistance member 415 in theguide groove 414 a of the deterrence reinforcement member 414, therebyreleasing fixation of the operation lever 403. Consequently, fixation ofthe guide wire 68 by the therapeutic instrument elevator base 27 isreleased.

[0366] In this embodiment, the following advantage can be demonstrated.That is, in this embodiment, since the braking mechanism 412 forrestraining the swivel operation force of the operation lever 403 of theelevator base operation knob 402 is incorporated in the elevator baseactuation mechanism 401, the fixed state of the guide wire 68 can bemaintained by fixing the therapeutic instrument elevator base 27 withthe therapeutic instrument elevator base 27 being swiveled to the set-upposition indicated by dotted lines in FIG. 5. Therefore, while the guidewire is fixed, there is no need to grip the operation lever 403, therebyadvantageously improving the working property of an operator.

[0367] It is to be noted that the braking mechanism 412 according tothis embodiment may be incorporated into the operation lever 72 of alater-described guide wire fixing elevator base 267. In this case, withthe guide wire fixing elevator base 267 being swiveled to the set-upposition shown in FIG. 57C, the fixed state of the guide wire 68 can bemaintained by fixing the guide wire fixing elevator base 267. Therefore,while the guide wire 68 is fixed, there is no need to grip the operationlever 72 of the guide wire fixing elevator base 267, therebyadvantageously improving the working property of an operator.

[0368] Further, FIG. 23 shows a first modification of the 10thembodiment. In this modification, an elastic member 416 consisting of,e.g., two flat springs 416 a and 416 b is arranged in the guide groove414 a of the deterrence reinforcement member 414 of the brakingmechanism 412 in place of the friction resistance member 415. Thiselastic member 416 is formed into such a shape as that the deterrentbody 413 is inserted between the two flat springs 416 a and 416 b andthe load is increased as the deterrent body 413 is inserted.Furthermore, the advantage similar to that of the braking mechanism 412according to an 11th embodiment can be also obtained in the elasticmember 416 of this modification.

[0369] Moreover, FIG. 51 shows a second modification of the 10thembodiment. In this modification, a notch 417 is provided to a tow knob264 which rotates around the axis along the circumferential direction ofthe operation portion 13 as in a 33rd embodiment in place of the brakingmechanism 412 according to the 10th embodiment. In addition, there isprovided a braking mechanism which fixes rotation of the tow knob 264 byreleasably engaging a protrusion 418 which protrudes through anon-illustrated elastic member with this notch 417. Additionally, theadvantage similar to that of the braking mechanism 412 according to the11th embodiment can be also obtained in this modification.

[0370] Further, FIGS. 24 to 27 show the 11th embodiment according to thepresent invention. In this embodiment, there is provided elevatoroperating means 471 having a set-up range selection type structurecapable of appropriately and selectively changing the set-up range ofthe therapeutic instrument elevator base 27 according to the 9thembodiment in a plurality of stages.

[0371] That is, to the elevator operating means 471 according to thisembodiment is provided an elevator base actuation mechanism 472 havingthe structure shown in FIGS. 24 and 25A inside the operation portion 13having the substantially the same structure as the endoscope 1 accordingto the 10th embodiment.

[0372] A segment stopper member 473 with the central axis of the fixingcylindrical body 406 at the center is provided to this elevator baseactuation mechanism 472. As shown in FIG. 26, a two-stage protrusionportion 475 which protrudes in the stepped form in the upward directionorthogonal to a flat base plane 474 is formed on one end portion side ofthe stopper member 473. To this two-stage protrusion portion 475 areprovided a low-stage first stopper 475 a and a high-stage second stopper475 b. The high-stage second stopper 475 b is arranged on the endportion side of the stopper member 473 at the rear of the low-stagefirst stopper 475 a. Additionally, the stopper member 473 is fixed tothe casing 13 a of the operation portion 13 by a set screw 476.

[0373] Further, a height of the first stopper 475 a is set in such amanner that elastic deformation of the operation lever 403 is enabled sothat the operation lever 403 of the elevator base operation knob 402 canget over the first stopper 475 a. Furthermore, the second stopper 475 bis set to a height that the operation lever 403 can not get over thesecond stopper 475 b by elastic deformation of the operation lever 403.Moreover, in the swivel operation of the elevator base operation knob402, the range of the elevator operation of the first stage isrestricted at a position B in FIG. 24 where the operation lever 403 ofthe elevator base operation knob 402 hustles against the fist stopper475 a. At this moment, by swiveling the operation lever 403 in theelevator operation range of the first stage from a position A to theposition B in FIG. 24, it is possible to perform the usual elevatoroperation for the therapeutic instrument for guiding the therapeuticinstrument and the like to a desired position as in the prior art.

[0374] In addition, by lifting the finger application portion 40S of theelevator base operation knob 402 in a direction indicated by an arrow inFIG. 25B at the position B and provoking elastic deformation of theoperation lever 403, the operation lever 403 can get over the fiststopper 475 a as shown in FIG. 25B. Further, after the operation lever403 is caused to get over the first stopper 475 a, the elevatoroperation range of the second stage can be restricted by swiveling theoperation lever 403 to a position C shown in FIG. 24 at which theoperation lever 403 hustles against the second stopper 475 b. Therefore,in this embodiment, the set-up range of the therapeutic instrumentelevator base 27 can be changed in two stages by the low-stage firststopper 475 a and the high-stage second stopper 475 b in the stoppermember 473 of the elevator operating means 471. Furthermore, at thisposition C, the guide wire 68 led from the channel opening portion 26 tothe outside is sandwiched and mechanically fixed between the end surfaceof the lead-in guide path 24 of the end hard portion 21 and thetherapeutic instrument elevator base 27.

[0375] The effect of this embodiment will now be described. In thisembodiment, in the swiveling operation of the elevator base operationknob 402, the elevator operation range of the first stage is restrictedat the position B shown in FIG. 24 at which the operation lever 403 ofthe elevator base operation knob 402 hustles against the low-stage firststopper 475 a in the stopper member 473 of the elevator operating means471. At this moment, by swiveling the operation lever 403 in theelevator operation range of the first stage from the position A to theposition B in FIG. 24, it is possible to perform the usual elevatoroperation for the therapeutic instrument for guiding the therapeuticinstrument and the like to a desired position as in the prior art.

[0376] Moreover, when fixing the guide wire 68, with the guide catheterbeing pulled into the therapeutic instrument insertion channel 23 as inthe first embodiment, the therapeutic instrument elevator base 27 israised by performing the swiveling operation of the operation lever 403.

[0377] At this moment, at the position B where the operation lever 403hustles against the first stopper 475 a, as indicated by an arrow inFIG. 25B, the operation lever 403 having come into contact with thefirst stopper 475 a is elastically deformed so as to be deflected bypushing up the finger application portion 405 toward the outside. As aresult, as indicated by dotted lines in FIG. 27, the operation lever 403can get over the first stopper 475 a.

[0378] In addition, after the operation lever 403 is caused to get overthe first stopper 475 a, the therapeutic instrument elevator base 27 canbe further raised by swiveling the operation lever 403 to the position Cshown in FIG. 24 at which the operation lever 403 hustles against thesecond stopper 475 b, thereby restricting the elevator operation rangeof the second stage. Additionally, at the position C, the guide wire 68led to the outside from the channel opening portion 26 is sandwiched andmechanically securely fixed between the end surface of the lead-in guidepath 24 of the end hard portion 21 and the therapeutic instrumentelevator base 27.

[0379] Therefore, in this embodiment, the low-stage first stopper 475 aand the high-stage second stopper 475 b are provided to the stoppermember 473 of the elevator operating means 471, and the set-up range ofthe therapeutic instrument elevator base 27 can be changed in two stagesby only changing the operation of the regularly used operation lever 403so as to be switched between the state in which the regularly usedoperation lever 403 abuts on the first stopper 475 a and the state inwhich the same abuts on the high-stage second stopper 475 b. Thus, sincethere is no need to newly provide a complicated operating means forchanging the set-up range of the therapeutic instrument elevator base27, there can be obtained an advantage that an operator is not confusedand the endoscope can be stably operated.

[0380] In addition, fine adjustment of the swiveling position of theoperation lever 403 does not have to be carried out in the case ofraising the therapeutic instrument and the case of fixing the guide wire68, and the operation lever can be used differently depending on thecase of simply raising the therapeutic instrument and the case of fixingthe guide wire 68, thereby reducing the burden of an operator duringexamination.

[0381] Additionally, after rotating the operation lever 403 of theelevator base operation knob 402 to the fixing position of the guidewire 68, the operation lever 403 does not hustle against the stoppermember 473 of the elevator operating means 471 in the operation forreleasing fixation of the guide wire 68 during which the operation lever403 is swiveled in the direction of the position A from the position Cthrough the position B, thereby readily performing the operation forreturning the therapeutic instrument elevator base 27 to the set-downposition.

[0382] Further, it is good enough that the clearance between thetherapeutic instrument elevator base 27 and the wire engagement groove321 according to the 9th embodiment is assured as in the prior art so asnot to prevent insertion/removal of the therapeutic instrument at theposition B. Furthermore, the clearance between the therapeuticinstrument elevator base 27 and the wire engagement groove 321 can benarrowed when moving from the position B to the position C, thusincreasing the fixing strength of the guide wire 68.

[0383] It is to be noted that the present invention may adopt thestructure in which a number of components can be reduced by integrallymolding the stopper member 473 with the operation portion casing 13 a ofthe operation portion 13. Moreover, although the above has described thestructure in which the two stoppers, i.e., the low-stage first stopper475 a and the high-stage second stopper 475 b are provided in thestopper member 473 in this embodiment, three or more stoppers may beprovided according to need.

[0384] In addition, although the above has described the structure inwhich the stopper member 473 is provided to the casing 13 a of theoperation portion 13 in this embodiment, the present invention is notrestricted thereto, and the stopper members may be provided at partswhere they come into contact with the operation lever 403, the fixingcylindrical body 406, the second link member 409 and the link member 44,respectively, so as not to deteriorate the set-up operability of thetherapeutic instrument elevator base 27.

[0385] Additionally, the shape of the stopper member 473 is notrestricted to the plate-like member described above, and an elasticmember 476 such as a flat spring can substitute as in the modificationof the 11th embodiment shown in FIG. 28. In this elastic member 476, afirst stopper 475 a for restricting the elevator operation range of thefirst stage is formed by a pair of protrusion portions 477 a and 477 awhich protrude on the trajectory of the operation lever 403, and asecond stopper 475 b for restricting the elevator operation range of thesecond stage is formed by a pair of protrusion portions 477 b and 477 bwhich protrude at positions away from the first stopper 475 a.

[0386] Further, FIGS. 29A, 29B and 30 show a 12th embodiment accordingto the present invention. In this embodiment, when the therapeuticinstrument elevator base 27 of the endoscope 1 according to the firstembodiment is raised, the therapeutic instrument elevator base 27 isarranged in such a manner that the therapeutic instrument elevator base27 is partially brought into an observation visual field 482 obtained byan object lens 481 of the object optical system of the endoscope 1 inFIG. 30.

[0387] It is to be noted that FIG. 29B shows an observation image 483obtained by the object lens 481 of the endoscope 1. Furthermore, theobject optical system of the endoscope 1 is arranged at a position atwhich a part of the guide wire 68 fixed by the wire engagement groove321 of the therapeutic instrument elevator base 27 shown in theobservation image 483 is focused.

[0388] The effect of this embodiment will now be described. In thisembodiment, as in the endoscope 1 according to the first embodiment,with the guide catheter being pulled into the therapeutic instrumentinsertion channel 23, the therapeutic instrument elevator base 27 andthe guide wire 68 fixed to the therapeutic instrument elevator base 27are brought into the visual field 482 of the object lens 481 of theobject optical system by raising the therapeutic instrument elevatorbase 27. Furthermore, when the therapeutic instrument elevator base 27is raised at the maximum level, the therapeutic instrument elevator base27 is arranged at the corner of the observation image 483 obtained bythe object lens 481 of the endoscope 1 so as to be capable of beingconfirmed as shown in FIG. 29B. At this moment, the object lens 481focuses on the guide wire 68. In this state, the guide catheter ispulled out at a blast, and any other instrument is inserted with theguide wire being used as a guide. When the end of the therapeuticinstrument hustles against the therapeutic instrument elevator base 27,the therapeutic instrument elevator base 27 is lowered, and the guidewire 68 is pushed out from the wire engagement groove 321 by thethrusting force from the therapeutic instrument when the therapeuticinstrument passes along the wire engagement groove 321, therebyreleasing fixation of the guide wire 68.

[0389] The following advantage can be obtained in this embodiment. Thatis, in this embodiment, as in the endoscope 1 according to the firstembodiment, the guide wire 68 can be readily fixed by only the usuallyperformed elevator operation of the therapeutic instrument elevator base27 in which the elevator operation knob 48 of the front operationportion 13 of the endoscope 1 is operated.

[0390] Also, in addition to the advantage similar to that of theendoscope 1 according to the first embodiment, by watching theobservation image obtained by the object lens 481 of the endoscope 1, itis possible to visually confirm whether the guide wire 68 has beenassuredly fixed. Thus, there is an advantage that an erroneous operationsuch as accidentally pulling out the unfixed guide wire 68 can beprevented from occurring.

[0391] Furthermore, since the therapeutic instrument elevator base 27 isbrought into the observation visual field 482 obtained by the objectlens 481 of the object optical system of the endoscope 1, there is anadvantage that the state of the therapeutic instrument elevator base 27having moved to the fixed position of the guide wire 68 can be visuallyconfirmed.

[0392] Incidentally, this embodiment is not necessarily restricted tothe endoscope 1 according to the first embodiment, and it can be appliedto all which have a mechanism for fixing the guide wire 68 by using theguide wire fixing member.

[0393] Moreover, FIG. 31A show a 13th embodiment according to thepresent invention. In this embodiment, an index 491 consisting of astripe marking is provided to the guide wire 68 which is fixed by theguide wire fixing means such as the therapeutic instrument elevator base27 of the endoscope 1 according to the 12th embodiment and brought intothe observation visual field 482 obtained by the object lens 481 of theobject optical system of the endoscope 1.

[0394] Incidentally, display indicative of displacement of a position ofthe guide wire 68 such as a scale 492 of a first modification shown inFIG. 31B or numerical FIGS. 493 of a second modification shown in FIG.31C can suffice the index 491.

[0395] The following advantage can be obtained in this embodiment. Thatis, the advantage similar to that of the 12th embodiment can be obtainedin this embodiment, and there is an advantage that the displacement ofthe guide wire 68 can be easily visually confirmed as well as theadvantage similar to that of the 12th embodiment.

[0396] In addition, FIG. 32A shows a 14th embodiment according to thepresent invention. In this embodiment, the position of the wireengagement groove 321 in the therapeutic instrument elevator base 27according to the first embodiment is set to be lower than thetherapeutic instrument guide plane 511 of the end cover 22 provided atthe end portion 17 of the insertion portion 12 of the endoscope 1.

[0397] It is to be noted that FIG. 32B shows the set-down state of theconventional treatment elevator base 27 when the guide wire 68 is fixed.As shown in FIG. 32B, in the conventional therapeutic instrumentelevator base 27, the position of the wire engagement groove 321 of thetherapeutic instrument elevator base 27 is arranged at a position higherthan the therapeutic instrument guide plane 511 of the end cover 22 ofthe insertion portion 12.

[0398] The effect of this embodiment will now be described. In thetherapeutic instrument elevator base 27 according to this embodiment, asin the therapeutic instrument elevator base 27 of the endoscope 1according to the first embodiment, after fixing the guide wire 68 andremoving the guide catheter, another therapeutic instrument is insertedwith the guide wire 68 functioning as a guide. At this moment, in thetherapeutic instrument elevator base 27 according to this embodiment, bycompletely setting down the therapeutic instrument elevator base 27, theguide wire 68 which has been pinched and fixed by the wire engagementgroove 321 is pushed up by the therapeutic instrument guide plane 511 ofthe end cover 22. Therefore, the guide wire 68 is pushed out from thewire engagement groove 321 by this thrusting force and fixation of theguide wire 68 is released.

[0399] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the guide wire 68 is pushed out from thewire engagement groove 321 by only the operation of the therapeuticinstrument elevator base 27, and fixation of the guide wire 68 can bereleased. Therefore, when the inserted therapeutic instrument passesalong the wire engagement grove 321, there is the advantage that theworking property can be further improved as compared with the method forreleasing fixation of the guide wire 68 by the thrusting force of thetherapeutic instrument.

[0400] Additionally, FIGS. 33A and 33B show a 15th embodiment accordingto the present invention. In this embodiment, in place of the wireengagement groove 321 according to the first embodiment, a guide wirefixing mechanism 102 for fixing the guide wire 68 is constituted byembedding an elastic member 101 made of a material having a largefriction resistance such as rubber in the front-side wall surface 26 aof the channel opening portion 26, raising the therapeutic instrumentelevator base 27 and welding the guide wire 68 to the elastic member 101with pressure by the therapeutic instrument elevator base 27, as shownin FIGS. 33A and 33B.

[0401] The effect of this embodiment will now be described. In thisembodiment, as in the first embodiment, after inserting the guide wire68 and the guide catheter into the therapeutic instrument insertionchannel 23, the therapeutic instrument elevator base 27 is raised by aset-up wire 30 as towing means by operating the elevator operation knob48 with the guide catheter being pulled into the lead-in guide path 24or the channel 23 when the guide wire 68 is fixed. At this moment, asindicated by dotted lines in FIG. 33B, the therapeutic instrumentelevator base 27 is raised to a position at which the guide wire 68 iswelded to the elastic member 101 with pressure by the therapeuticinstrument elevator base 27. When the guide wire 68 is sandwichedbetween the therapeutic instrument elevator base 27 and the elasticmember 101, the guide wire 68 does not slip by the friction resistanceof the elastic member 101 but fixed.

[0402] In this embodiment, the guide wire 68 can be fixed by raising thetherapeutic instrument elevator base 27 by the operation of the elevatoroperation knob 48 on the front operation portion 13 of the endoscope 1and sandwiching the guide wire 68 between the therapeutic instrumentelevator base 27 and the elastic member 101, thereby obtaining theadvantage similar to that of the first embodiment.

[0403] Further, in this embodiment in particular, only embedding theelastic member 101 in the front-side wall surface 26 a of the channelopening portion 26 can suffice, and an additional component such as animpetus giving mechanism does not have to be newly provided. Therefore,the structure of the end portion 17 of the endoscope 1 is notcomplicated, which is similar to the prior art.

[0404] Incidentally, in the endoscope 1 which is of a type that the endcover 22 constituted by the elastic member can be attached/detached, asin a modification shown in FIG. 34, the guide wire fixing portion 103which is extended to the front-side wall surface 26 a of the channelopening portion 26 may be provided integrally with the end cover 22 at apart corresponding to the channel opening portion 26 in the end cover22. In this case, in the endoscope 1 in which the end cover 22 can beattached/detached, the guide wire fixing mechanism 102 can be easilyprovided to a current scope by replacing the conventional end cover withthe end cover 22 according to this embodiment.

[0405] Furthermore, the elastic member 101 according to the 15thembodiment may be substituted by a magnet. In this case, as in the firstembodiment, after inserting the guide catheter and the metal guide wire68 into the therapeutic instrument insertion channel 23, the therapeuticinstrument elevator base 27 is raised by the elevator operation knob 48in the operation portion 13 when the guide catheter is drawn into thechannel opening portion 26. As a result, the elevator guide wire 68 isattracted to the magnet on the front-side wall surface 26 a of thechannel opening portion 26 by the magnetic force.

[0406] Thereafter, the guide catheter is completely pulled out, and atherapeutic instrument which is subsequently used is inserted from thebase end side of the guide wire 68. Then, the therapeutic instrumentwhich is subsequently used is inserted into the therapeutic instrumentinsertion channel 23 with the guide wire 68 functioning as a guide. Atthis moment, when the therapeutic instrument passes the position atwhich the guide wire 68 is fixed by the magnet, the attraction force isweakened, and the guide wire 68 moves away from the magnet. Moreover,the guide wire 68 is inserted into a pancreatic/hepatic duct (notshown). Therefore, the advantage which is the same as the 15thembodiment can be also obtained in this case.

[0407] In addition, in the endoscope 1 in which the end cover 22 can beattached/detached, the magnet may be embedded in a part corresponding tothe front-side wall surface 26 a of the channel opening portion 26 inthe end cover 22.

[0408] Additionally, FIGS. 35A and 35B show a 16th embodiment accordingto the present invention. In this embodiment, the guide wire engagementgroove 441 is provided on an inner wall surface 25 a of an accommodationchamber 25 of the therapeutic instrument elevator base 27 in the endcover 22 provided at the end portion 17 of the endoscope 1 according tothe first embodiment. The relationship between a groove width M1 of theguide wire engagement groove 441 and a wire diameter D1 of the guidewire 68 is set to, e.g., “M1≦D1”. The groove width M1 of the guide wireengagement groove 441 is set to a size that the guide wire 68 fits inthe guide wire engagement groove 441 when the guide wire 68 is pushed ina direction of the guide wire engagement groove 441 and the peripheralpart of the guide wire engagement groove 441 in the end cover 22 iselastically deformed.

[0409] Further, a guide plane 442 which guides the guide wire 68 in adirection of the guide wire engagement groove 441 is formed at thetherapeutic instrument elevator base 27. As shown in FIG. 35A, the guideplane 442 is formed by an inclined plane notched on the side surface ofthe accommodation chamber 25 opposed to the guide wire engagement groove441 in the state that the therapeutic instrument elevator base 27 islowered and accommodated in the accommodation chamber 25 (standbyposition) as shown in FIG. 35A.

[0410] Furthermore, in the operation for raising the therapeuticinstrument elevator base 27, as the therapeutic instrument elevator base27 swivels from the standby position to the therapeutic instrumentset-up position with the elevator base swivel supporting point 28 at thecenter, the guide wire 68 is guided to the direction of the guide wireengagement groove 441 by the guide plane 442 of the therapeuticinstrument elevator base 27, and the guide wire 68 is partially fittedin the guide wire engagement groove 441. In this state, the side surfaceof the therapeutic instrument elevator base 27 pushes the guide wire 68by further raising the therapeutic instrument elevator base 27 as shownin FIG. 35B, and the guide wire 68 is pushed and fixed between the guidewire engagement groove 441 and the side surface of the therapeuticinstrument elevator base 27.

[0411] The effect of this embodiment will now be described. In thisembodiment, as in the first embodiment, the guide wire 68 is guided tothe guide wire engagement groove 441 by the guide plane 442 of thetherapeutic instrument elevator base 27 when the therapeutic instrumentelevator base 27 is raised with the guide catheter being accommodated inthe therapeutic instrument insertion channel 23, and the guide wire 68is partially fitted in the guide wire engagement groove 441.

[0412] In this state, the side surface of the therapeutic instrumentelevator base 27 pushes the guide sire 68 by further raising thetherapeutic instrument elevator base 27, and the guide wire 68 is pushedand fixed between the guide wire engagement groove 441 and the sidesurface of the therapeutic instrument elevator base 27. At this moment,the movement of the guide wire 68 trying to go out of the guide wireengagement groove 441 can be restricted by maintaining the set-up stateof the treatment elevator base 27.

[0413] Thereafter, the guide catheter is pulled out from the therapeuticinstrument insertion channel 23 at a blast. Another therapeuticinstrument is subsequently inserted with the guide wire 68 as a guide.At this moment, when the end of the therapeutic instrument hustlesagainst the therapeutic instrument elevator base 27, the therapeuticinstrument elevator base 27 is lowered by the operation of the elevatoroperation knob 48. Further, when another therapeutic instrument passesalong the guide wire engagement groove 441, the guide wire 68 is pushedout from the guide wire engagement groove 441 by the thrusting forcefrom this therapeutic instrument, thereby releasing fixation of theguide wire 68.

[0414] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the advantage similar to that of theendoscope 1 according to the first embodiment can be obtained. Inaddition to this, further secure fixation is enabled by sandwiching theguide wire 68 inserted into the guide wire engagement groove 441 betweenthe therapeutic instrument elevator base 27 and the guide wireengagement groove 441 and fixing it.

[0415] Furthermore, FIGS. 36A and 36B show a 17th embodiment accordingto the present invention. In this embodiment, the guide wire engagementgroove 441 according to a 16th embodiment is provided on an inner wallsurface 25 b on the end hard portion 21 side having an object lens 445of the object optical system in the accommodation chamber 25 of thetherapeutic instrument elevator base 27.

[0416] It is to be noted that the groove width of the guide wireengagement groove 441 is similarly set as in the 16th embodiment.

[0417] Moreover, a guide wall 443 which restricts a protruding directionof the therapeutic instrument to the end portion on the opposite side tothe inner wall surface 25 b on the end hard portion 21 side is providedto the end portion of the therapeutic instrument elevator base 27. Aguide plane 444 for guiding the guide wire 68 to the direction of theguide wire engagement groove 441 is formed on the side of the guide wall443.

[0418] In this embodiment, the following effect can be demonstrated.That is, in this embodiment, the advantage similar to that of the 16thembodiment can be obtained. In addition to this, since the guide wall443 for restricting the protruding direction of the therapeuticinstrument to the end on the opposite side to the inner wall surface 25b on the end hard portion 21 side is provided to the end portion of thetherapeutic instrument elevator base 27, the therapeutic instrument canbe caused to protrude toward the object lens 445 side of the end hardportion 21 by the guide wall 443 of the therapeutic instrument elevatorbase 27 when raising the therapeutic instrument elevator base 27,thereby improving the operability of the therapeutic instrument.

[0419] In addition, FIGS. 37A to 37D show an 18th embodiment. In thisembodiment, a guide wire fixing mechanism 381 having a differentstructure substitutes for the wire engagement groove 321 according tothe first embodiment.

[0420] That is, a first impetus giving member 382 and a second impetusgiving member 383 for releasably fixing the guide wire 68 when the guidewire 68 is in the pinched state are provided to the guide wire fixingmechanism 381 according to this embodiment. As shown in FIG. 37A, thefirst impetus giving member 382 is fixed to the front-side end portionof the channel opening portion 26 of the end hard portion 21 provided atthe end portion 17 of the insertion portion 12 in the endoscope 1.Additionally, the second impetus giving member 383 is provided next tothe first impetus giving member 382 so as to be capable of beingconnected/disconnected to/from the first impetus giving member 382.

[0421] Further, a therapeutic instrument guide plane 384 of each of theimpetus giving members 382 and 383 is formed by whittling away thosemembers in accordance with the therapeutic instrument shape.Furthermore, as shown in FIG. 37B, a guiding protrusion 385 is providedto the second impetus giving member 383 at a position on the oppositeside to the therapeutic instrument guide plane 384.

[0422] Moreover, a guide groove 386 of the second impetus giving member383 is provided on a wall surface of the end hard portion 21 on thefront side. The guiding protrusion 385 of the second impetus givingmember 383 is movably engaged with the guide groove 386. In addition,the second impetus giving member 383 is movably supported substantiallyvertically with respect to the lead-in guide path 24 along the guidegroove 386.

[0423] In addition, a tow wire 387 is provided on the side of the secondimpetus giving member 383 opposed to the first impetus giving member382. A rotatable roller 388 is connected to the end portion of the towwire 387.

[0424] Additionally, the base end portion of the tow wire 387 is led tothe operation portion 13 through a tow wire channel 389 and connected toa non-illustrated link mechanism. Further, as in the first embodiment,the towing operation of the tow wire 387 is enabled by the operation ofthe operation lever 72 on the front side.

[0425] Further, an accommodation chamber 390 is provided to the firstimpetus giving member 382 and the second impetus giving member 383 onthe opposite side to the therapeutic instrument guide plane 384. Acoil-like spring member 391 for giving impetus in a direction alongwhich the second impetus giving member 383 is moved away from the firstimpetus giving member 382 is provided in this accommodation chamber 390.This spring member 391 is arranged substantially vertically with respectto the lead-in guide path 24.

[0426] Furthermore, in this embodiment, as shown in FIG. 37C, in regardto a distance L1 between the first impetus giving member 382 and thesecond impetus giving member 383 in the usual state, the relationshipbetween a wire diameter D1 of the guide wire 68 and an outside diameterD2 of the therapeutic instrument or any other therapeutic instrumentsuch as the guide catheter is set to “D1<L1<D2”.

[0427] Moreover, at the time of towing by the operation lever 72, asshown in FIG. 37D, a distance L2 between the first impetus giving member382 and the second impetus giving member 383 when the second impetusgiving member has moved is set to “L2<D1<D2”.

[0428] In addition, a chamfered portion 392 obtained by obliquelycutting a corner portion is provided at a part of the second impetusgiving member 383 which firstly comes into contact with a roller 388 onthe tow wire 387 side.

[0429] The effect of this embodiment will now be described. When usingthe endoscope 1 of this embodiment, as in the 29th embodiment, afterinserting the guide catheter and the guide wire 68 into the body throughthe channel 23, the elevator operation knob 48 of the therapeuticinstrument elevator base 27 is operated with the guide catheter beingpulled into the lead-in guide path 24 or the channel 23. The set-up wire30 is towed by the operation of the elevator operation knob 48, and thetherapeutic instrument elevator base 27 is swiveled around the elevatorbase swivel supporting point 28 and raised as indicated by dotted linesin FIG. 37B.

[0430] At this moment, when the guide wire 68 is raised by raising thetherapeutic instrument elevator base 27, the guide wire 68 is guidedbetween the first impetus giving member 382 and the second impetusgiving member 383 and fitted therein as shown in FIG. 37C. In thisstate, the roller 388 is pulled next to the second impetus giving member383 through the tow wire 387 by the operation lever 72. As a result, asshown in FIG. 37D, the second impetus giving member 383 is pushed outalong the guide groove 386 and comes close to the first impetus givingmember 382. Therefore, a width of a space between the first impetusgiving member 382 and the second impetus giving member 383 is narrowed,and the guide wire 68 is sandwiched and mechanically fixed.

[0431] In addition, after confirming that the guide wire 68 is fixed,the guide catheter is completely pulled outside the therapeuticinstrument insertion channel 23 from the operation portion 13 side ofthe endoscope 1.

[0432] Thereafter, a therapeutic instrument which is subsequently usedis inserted from the base end portion side of the guide wire 68. At thismoment, with the guide wire 68 being used as a guide, the therapeuticinstrument is inserted into the therapeutic instrument insertion channel23. Then, when the therapeutic instrument hustles against the bothimpetus giving members 382 and 383, the tow wire 387 is loosened byoperating the operation lever 72, and the second impetus giving member383 is pushed back to its original position by the force of the springmember 391. Consequently, fixation of the guide wire 68 is released, andthe therapeutic instrument is inserted into a pancreatic/hepatic duct(not shown).

[0433] In this embodiment, as in the first embodiment, the guide wire 68can be easily fixed by the operation of the operation lever 72 of thefront-side operation portion 13 of the endoscope 1, and the advantagesimilar to that of the first embodiment can be obtained.

[0434] Additionally, FIGS. 38 and 39 show a 19th embodiment according tothe present invention. In this embodiment, a substantially-U-shapedguide wire fixture 121 is provided to the guide plane 29 of thetherapeutic instrument elevator base 27 as shown in FIGS. 38 and 39 inplace of the wire engagement grove 321 according to the firstembodiment.

[0435] As illustrated in FIG. 39, dimensions La and Lb of the guide wirefixture 121 are set to the relationship of “La, Lb>d” with respect tothe outside diameter dimension d of the therapeutic instrument insertionchannel 23.

[0436] The effect of this embodiment will now be described. In thisembodiment, as in the first embodiment, after inserting the guide wire68 and the guide catheter into the therapeutic instrument insertionchannel 23, the guide catheter is operated to be pulled into the lead-inguide path 24 or the channel 23 when the guide wire 68 is fixed. Whenthe guide catheter enters the channel 23 at the time of removing theguide catheter, the guide wire 68 is sandwiched between the guide wirefixture 121 and the lead-in guide path lower surface 24 a of the endhard portion 21 by raising the therapeutic instrument elevator base 27by performing the elevator operation for the therapeutic instrumentelevator base 27, thereby fixing the guide wire 68.

[0437] In this embodiment, the therapeutic instrument elevator base 27is raised by the operation by the elevator operation knob 48 on thefront operation portion 13 side of the endoscope 1, and the guide wire68 can be fixed by sandwiching the guide wire 68 between the guide wirefixture 121 of the therapeutic instrument elevator base 27 and thelead-in guide path lower surface 24 a of the end hard portion 21,thereby obtaining the advantage similar to that of the first embodiment.

[0438] Further, in this embodiment in particular, insertion of thetherapeutic instrument in an usual case can not be avoided by the guidewire fixture 121 of the therapeutic instrument elevator base 27 bysecuring the opening portion of the guide wire fixture 121 so as to bewider than the therapeutic instrument insertion channel 23, and theguide wire 68 can be fixed by raising the therapeutic instrumentelevator base 27.

[0439] Furthermore, FIG. 40 shows a 20th embodiment according to thepresent invention. In this embodiment, the structure of the end portion17 of the insertion portion 12 in the endoscope 1 according to the firstembodiment is changed as follows.

[0440] That is, an engagement convex portion 341 forfixing the guidewire 68 is provided so as to protrude at a peripheral edge part of thechannel opening portion 26 of the end cover 22 in place of the wireengagement groove 331 according to the second embodiment. Thisengagement convex portion 341 is constituted to be welded to the guideplane 29 of the therapeutic instrument elevator base 27 with pressure asindicated by dotted lines in FIG. 40 when the therapeutic instrumentelevator base 27 is raised, and the guide wire 68 is sandwiched betweenthe engagement convex portion 341 and the therapeutic instrumentelevator base 27 so that the guide wire 68 is releasably engaged.

[0441] The effect of this embodiment will now be described. When usingthe endoscope 1 according to this embodiment, as in the firstembodiment, after inserting the guide catheter and the guide wire 68into the body through the channel 23, the elevator operation knob 48 ofthe therapeutic instrument elevator base 27 is operated with the guidecatheter being pulled into the introduction guide path 24 or the channel23. The towing operation of the set-up wire 30 is performed with themanipulation of the elevator operation knob 48, and the therapeuticinstrument elevator base 27 is swiveled around the elevator base swivelsupporting point 28 and raised as indicated by dotted lines in FIG. 40.

[0442] Moreover, the guide plane 29 of the therapeutic instrumentelevator base 27 is welded with pressure to the engagement convexportion 341 provided at the peripheral edge part of the channel openingportion 26 of the end cover 22 when the therapeutic instrument elevatorbase 27 is raised, and the guide wire 68 is sandwiched between theengagement convex portion 341 and the therapeutic instrument elevatorbase 27 and releasably engaged. In this state, the guide wire 68 ismechanically fixed.

[0443] In this embodiment, the following advantage can be demonstrated.That is, the guide wire 68 can be easily fixed by only the elevatoroperation of the therapeutic instrument elevator base 27 which isusually carried out on the front operation portion 13 side of theendoscope 1 in this embodiment. Therefore, the advantage similar to thatof the first embodiment can be also obtained in this embodiment.

[0444] Also, in this embodiment, the structure of the end portion 17 ofthe insertion portion 12 can be simplified since a movable typeconstituent part does not have to be newly provided at the end portion17 of the insertion portion 12 of the endoscope 1, in addition to theadvantage of the first embodiment.

[0445] Additionally, even though the guide wire 68 cannot be pinchedbecause of the set-up angle of the therapeutic instrument elevator base27 in the conventional elevator base 27, if the endoscope 1 adopts thedetachable end cover 22 in this embodiment, the guide wire 68 can befixed by replacing such a cover with the end cover 22 having aprotruding engagement convex portion 341 for fixing the guide wire 68 tothe peripheral edge part of the channel opening portion 26 of the endcover 22.

[0446] Further, FIGS. 41A and 41B show a 21st embodiment according tothe present invention. In this embodiment, guide wire fixing means 351having a different structure is provided in place of the wire engagementgroove 32 according to the first embodiment.

[0447] That is, a guide wire fixing member 352 for engaging the guidewire 68 is provided to the guide wire fixing means 351 according to thisembodiment at a peripheral edge part of the channel opening portion 26of the end hard portion 21. As shown in FIG. 41B, two guide wireidentification members 353 a and 353 b made of stainless steel wireswhich are pendent toward the inner side of the opening portion 26 fromthe both sides of the channel opening portion 26 of the end hard portion21 are provided to the guide wire fixing member 352. The base endportions of the guide wire identification members 353 a and 353 b areembedded in the both side portions of the channel opening portion 26 ofthe end hard portion 21. Furthermore, at least two guide wire fixingmember insertion holes 354 a and 354 b are provided on the both sides ofthe side surface of the channel opening portion 26.

[0448] Moreover, one of the two guide wire identification members 353 aand 353 b, namely, the first guide wire identification member 353 a isextended from the upper edge side to the inner side of the channelopening portion 26 and bent toward the left side in FIG. 41B. Inaddition, the other second guide wire identification member 353 b isextended from the lower edge side to the inner side of the channelopening portion 26 and bent toward the right side in FIG. 41B.Respective extended parts 353 a 1 and 353 b 1 of the two guide wireidentification members 353 a and 353 b are arranged so as to be spacedfrom and opposed to each other substantially in parallel. Additionally,a space S having an appropriate widthwise dimension L is formed betweenthe respective extended parts 353 a 1 and 353 b 1 of these guide wireidentification members 353 a and 353 b. This space S is set so as to belarger than the outside diameter dimension of the guide wire 68, forexample.

[0449] Further, a guide wire fixture 355 formed by a filate memberhaving no elastic property, e.g., a surgical thread is provided to theguide wire fixing means 351. One end portion of the guide wire fixture355 is fixed to the first guide wire identification member 353 a on theupper side in FIG. 41B. Furthermore, after passing through the guidewire fixing member insertion hole 354 a on the upper side (first guidewire identification member 353 a side) in FIG. 41B of the channelopening portion 26, the guide wire fixture 355 cuts across the openingportion 26 and passes through the guide wire fixing member insertionhole 354 b on the lower side (second guide wire identification member353 b side) in FIG. 41B. Then, the other end portion side of the guidewire fixture 355 is fixed to the second guide wire identification member353 b. As a result, the guide wire fixture 355 is attached so as to becross-linking between the both side portions on the opening portion 26.

[0450] The effect of this embodiment will now be described. When usingthe endoscope 1 according to this embodiment, as in the firstembodiment, the guide catheter and the guide wire 68 are inserted intothe body through the channel 23 and set in such a manner that theyprotrude from the channel opening portion 26 of the end portion 17 inthe endoscope 1. In this state, when the therapeutic instrument elevatorbase 27 is raised by operating the elevator operation knob 48 of theoperation portion 13 in the endoscope 1, the guide catheter enters thespace between the respective extended parts 353 a 1 and 353 b 1 of theguide wire identification members 353 a and 353 b.

[0451] At this moment, a material having a larger diameter than that ofthe guide wire 68, e.g., the guide catheter enlarges the space betweenthe respective extended parts 353 a 1 and 353 b 1 of the guide wireidentification members 353 a and 353 b, and the tensile force of theguide wire fixture 355 hence relaxes. The guide catheter is raisedwithout interfering with the guide wire fixture 355.

[0452] Further, when raising the guide wire 68, since the guide wire 68passes between the respective extended parts 353 a 1 and 353 b 1 of thetwo guide wire identification members 353 a and 353 b, the tensile forceof the guide wire fixture 355 fixed to the guide wire identificationmembers 353 a and 353 b does not relax. Therefore, in this case, byraising the therapeutic instrument elevator base 27, the guide wire 68receives the force in the opposite directions by the therapeuticinstrument elevator base 27 and the guide wire fixture 355 in theshearing manner, and the guide wire 68 is hence bent into thesubstantially L shape and fixed.

[0453] The following effect can be demonstrated in this embodiment. Thatis, in this embodiment, since the guide wire fixing member 352 forengaging the guide wire 68 with the peripheral edge part of the channelopening portion 26 of the end hard portion 21 is provided, the guidewire 68 can be readily fixed by only the elevator operation for thetherapeutic instrument elevator base 27 which is usually performed byoperating the elevator operation knob 48 of the front operation portion13 of the endoscope 1. Therefore, the advantage similar to that of thefirst embodiment can be also obtained in this embodiment.

[0454] Furthermore, FIGS. 42 to 44 show a 22nd embodiment according tothe present invention. In this embodiment, the inner structure of theend portion 17 of the insertion portion 12 in the endoscope 1 accordingto the first embodiment is changed as follows.

[0455] That is, in this embodiment, a guide wire fixing memberaccommodation chamber 53 is formed at the end hard portion 21 of the endportion 17 of the insertion portion 12 in the endoscope 1. The guidewire fixture 532 formed by an insulating member is accommodated in thisaccommodation chamber 531 so as to be capable of protruding/retractingfrom/to the lead-in guide path 24 communicating with the channel openingportion 26. The insulating member of the guide wire fixture 532 is usedfor preventing sparks caused when the guide wire fixture 532 isaccidentally brought into contact with the endoscope end portion 17 whena high frequency flows with a papillotomy knife and the like beinginserted in the therapeutic instrument insertion channel 23.

[0456] Moreover, as shown in FIG. 44, a substantially-T-shaped guidingprotrusion 533 is provided so as to protrude from the upper portion ofthe guide wire fixture 532. A guide groove 534 having a shapecorresponding to the guiding protrusion 533 is formed at the end hardportion 21. This guide groove 534 is conjugated to the guide wire fixingmember accommodation chamber 531. In addition, the guiding protrusion533 of the guide wire fixture 532 is engaged with the guiding groove 534of the end hard portion 21.

[0457] Additionally, a coil-like spring member 535 for giving impetus tothe guide wire fixture 532 in the outer direction (direction toward theend of the endoscope 1) of the guide wire fixing member accommodationchamber 531 is provided in this accommodation chamber 531.

[0458] Further, the end portion of the tow wire 536 is fixed to theguide wire fixture 532. This tow wire 536 is led to the operationportion 13 through the tow wire channel 537 and connected to anon-illustrated link mechanism. As a result, as in the first embodiment,the towing operation of the guide wire fixture 532 is enabled throughthe tow wire 536 by the operation of the operation lever 72 on the frontside.

[0459] The effect of this embodiment will now be described. In thisembodiment, when performing the operation for fixing the guide wire 68to the end portion 17 of the insertion portion 12 in the endoscope 1 atthe time of replacing the guide catheter inserted into the body throughthe guide wire 68 with another therapeutic instrument, as in the firstembodiment, the operation for loosening the tow wire 536 is carried outby manipulating the operation lever 72 with the guide catheter beingpulled in the therapeutic instrument insertion channel 23. At thismoment, the guide wire fixture 532 is pushed out in the direction towardthe end of the insertion portion outside the accommodation chamber 531by the spring force of the spring member 535 and caused to protrude intothe lead-in guide path 24 as shown in FIG. 43. Consequently, the guidewire 68 raised by the therapeutic instrument elevator base 27 issandwiched between the guide wire fixture 532 and the therapeuticinstrument elevator base 27 and mechanically fixed.

[0460] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the advantage similar to that of the firstembodiment can be obtained. In addition to this, when performing theoperation for fixing the guide wire 68 to the end portion 17 of theinsertion portion 12 in the endoscope 1, the guide wire 68 can be fixedby the surface contact state between the guide wire fixture 532 and thetherapeutic instrument elevator base 27, thereby further securely fixingthe guide wire 68 as compared with the prior art.

[0461] Further, FIG. 45 shows a 23rd embodiment according to the presentinvention. In this embodiment, an index 451 indicative of an insertionposition of the guide catheter 67 is provided to the base end portion ofthe guide catheter 67 according to the seventh embodiment. In thisembodiment, if the guide catheter 67 or the therapeutic instrument isinserted into the therapeutic instrument insertion channel 23 of theendoscope 1, the index 451 of the guide catheter 67 is arranged at aposition corresponding to the insertion opening portion 61 of theoperation portion 13 when the guide catheter 67 or the therapeuticinstrument is drawn to a position at which the guide wire 68 can befixed. Furthermore, the index 451 of the guide catheter 67 may be avisual indicator having a color and the like or an indicator withirregularities that can be touched by a hand to feel.

[0462] The effect of this embodiment will now be described. In thisembodiment, as in the first embodiment, after inserting the guidecatheter 67 into the therapeutic instrument insertion channel 23 fromthe insertion opening portion 61 of the operation portion 13 in theendoscope 1, the guide catheter 67 is caused to protrude toward theoutside from the channel opening portion 26 and inserted into apancreatic/hepatic duct (not shown) in the papillotomy manner.

[0463] Then, in the operation for replacing the currently used guidecatheter 67 with a therapeutic instrument which is subsequently used,the guide wire 68 is first inserted from the mouth ring of the guidecatheter 67 on the base end side. Thereafter, an observation image(endoscopic image) of the endoscope 1 is used to confirm that the endportion of the guide wire has entered the pancreatic/hepatic duct (notshown), and the base end side of the guide wire 68 is gripped by a handso that the guide wire 68 can not move. Subsequently, in this state, theoperation for pulling out the guide catheter 67 is conducted.

[0464] At this moment, the endoscopic image is used to confirm that theguide catheter 67 has been drawn out from a papilla (not shown), and theguide wire 67 is further pulled out. Then, with the end of the guidecatheter 67 being accommodated in the channel opening portion 26 at theend of the endoscope 1, the index 451 appears on a part of the guidecatheter which is exposed from the insertion opening portion 61 of theoperation portion 13. Therefore, the position of the end of the guidecatheter 67 can be assuredly confirmed when an operator or a worker seesthe index 541.

[0465] Then, when the state that the end of the guide catheter 67 isaccommodated in the channel opening portion 26 at the end of theendoscope 1 is confirmed, the guide wire 68 can be fixed by operatingthe later-described guide wire fixture 69 and the like.

[0466] In this embodiment, the following advantage can be obtained. Thatis, in this embodiment, the index 451 indicative of an insertionposition of the guide catheter 67 is provided at the base end portion ofthe guide catheter 67. When the guide catheter 67 or the therapeuticinstrument is inserted into the therapeutic instrument insertion channel23 of the endoscope 1, the index 451 is arranged at a positioncorresponding to the insertion opening portion 61 of the operationportion 13 at the point in time that the guide catheter 67 or thetherapeutic instrument is pulled to the position at which the guide wire68 can be fixed. Therefore, the position of the end of the guidecatheter 67 can be assuredly confirmed when an operator or a worker seesthis index 451, and there is an advantage that the timing for operatingthe guide wire fixture 69 can be readily acknowledged.

[0467] Further, FIGS. 46A and 46B show a 24th embodiment according tothe present invention. A guide wire fixture 69 formed by a wire which isopened in the loop form and has a snare shape is provided to the notchportion 17 a of the end portion 17 in the endoscope 1. The end openingportion 71 a of the tow wire channel 71 which is inserted into theinsertion portion 12 is provided on a rear end wall surface 17 b of thenotch portion 17 a of the end portion 17. The tow wire 75 for towing theguide wire fixture 69 is inserted into the tow wire channel 71. Further,the base end portion of the guide wire fixture 69 is connected to theend portion of the tow wire 75.

[0468] Furthermore, the tow wire 75 is led to the operation portion 13side through the tow wire channel 71. Moreover, the base end portion ofthe tow wire 75 is connected to the operation lever (operationtransmitting means) 72 (see FIG. 1) of the operation portion 13 throughthe link mechanism having the same structure as the above-describedelevator base actuation mechanism 41.

[0469] Incidentally, since the link mechanism has the same structure asthe above-mentioned elevator base actuation mechanism 41, itsexplanation is omitted. Moreover, the guide wire fixture 69 isconfigured to be capable of moving to a protrusion position at which theguide wire fixture is caused to protrude on the upper surface positionof the channel opening portion 26 from the end opening portion 71 a ofthe tow wire channel 71 as shown in FIG. 46A and a accommodationposition at which the guide wire fixture 69 is accommodated on the endopening portion 71 a side of the tow wire channel 71 as shown in FIG.46B by the operation of the operation lever 72.

[0470] In addition, when the guide wire fixture 69 protrudes at theupper surface position of the channel opening portion 26 from the endopening portion 71 a of the tow wire channel 71, the guide wire fixture69 is opened in the state where the wire is opened in the loop form.

[0471] Incidentally, when the guide wire fixture 69 is opened, the guidewire fixture 69 is set so as to have dimensions that it can cover theentire channel opening portion 26 as shown in FIG. 46a and be elongatedwith respect to the axial direction of the insertion portion 12 in theendoscope 1 in the substantially elliptical shape, and it is configuredto be opened so that the length of the opening portion which is openedin the loop form in the lengthwise direction can be approximately 20 mm.

[0472] Additionally, a protrusion 70 capable of temporarily fixing theguide wire fixture 69 on the end side away from the channel openingportion 26 is provided to the notch portion 17 a of the end portion 17in the endoscope 1. Further, by engaging the guide wire fixture 69 withits end portion being hooked on this protrusion 70, the guide wirefixture 69 can be held at the standby position.

[0473] Further, when operating the operation lever 72 in the operationportion 13, the towing operation of the tow wire 75 is effected by thelink mechanism having the same structure as the elevator base actuationmechanism 41, and the guide wire fixture 69 is moved to theaccommodation position at which the guide wire fixture 69 isaccommodated on the end opening portion 71 a side of the tow wirechannel 71 as shown in FIG. 46B. At this moment, an opening area of theloop-like opening portion formed by the wire of the guide wire fixture69 is gradually reduced with the movement of the guide wire fixture 69that the guide wire fixture 69 is pulled to the end opening portion 71 aside of the tow wire channel 71. Furthermore, when a large part of theguide wire fixture 69 is accommodated on the end opening portion 71 aside of the tow wire channel 71, the guide wire 68 which is insertedinto the therapeutic instrument insertion channel 23 and led to theoutside from the channel opening portion 26 as shown in FIG. 46B ispressed against the edge part of the channel opening portion 26 on therear end portion side and fixed.

[0474] The effect of this embodiment will now be described. When usingthe endoscope 1 according to this embodiment, the guide wire fixture 69is previously moved to the protrusion position at which the guide wirefixture 69 is caused to protrude at the upper surface position of thechannel opening portion 26 from the end opening portion 71 a of the towwire channel 71 as shown in FIG. 46A. At this moment, with theloop-shaped opening portion formed by the wire of the guide wire fixture69 being expanded around the channel opening portion 26, the end portionof the guide wire fixture 69 is hooked on the protrusion 70 of the endportion 17 in the endoscope 1 and engaged, thereby holding the guidewire fixture 69 at the standby position.

[0475] In this state, the guide catheter 67 is inserted into thetherapeutic insertion channel 23 from the insertion opening portion 61of the operation portion 13 in the endoscope 1. Then, the guide catheter67 is caused to protrude to the outer side from the channel openingportion 26 and inserted into a pancreatic/hepatic duct (not shown) inthe papillotomy manner.

[0476] Thereafter, in the operation for replacing the currently usedguide catheter 67 with the therapeutic instrument which is subsequentlyused, the guide wire 68 is first inserted from the mouth ring of theguide catheter 67 on the base end side thereof. Then, an observationimage (endoscopic image) of the endoscope 1 is used to confirm that theend portion of the guide wire 68 has been inserted into thepancreatic/hepatic duct (not shown), and the base end side of the guidewire 68 is gripped by a hand so that the guide wire 68 can not move.Subsequently, in this state, the operation for pulling out the guidecatheter 67 is performed.

[0477] At this moment, after confirming in an endoscopic image that theguide catheter 67 has been pulled out from a papilla (not shown), theguide catheter 67 is further pulled out. Then, with the end of the guidecatheter 67 being accommodated in the channel opening portion 26 at theend of the endoscope 1, the end opening portion 71 a of the tow wirechannel 71 is narrowed down as shown in FIG. 46B by towing the guidewire fixture 73 by the operation lever 72, and the guide wire 68 ledfrom the channel opening portion 26 to the outer side is pressed againstthe edge part of the channel opening portion 26 on the rear edge portionside and mechanically fixed.

[0478] Moreover, after confirming that the guide wire 68 has been fixed,the guide catheter 67 is completely pulled to the outside of thetherapeutic instrument insertion channel 23 from the operation portion13 side of the endoscope 1.

[0479] Then, a therapeutic instrument which is subsequently used isinserted from the base end side of the guide wire 68. At this moment,with the guide wire 68 being used as a guide, the therapeutic instrumentis inserted into the therapeutic instrument insertion channel 23. Then,when the therapeutic instrument hustles against the guide wire fixture69, fixation of the guide wire 68 by the guide wire fixture 69 isreleased by operating the operation lever 72, and the therapeuticinstrument is inserted into the pancreatic/hepatic duct (not shown).Thereafter, the therapeutic instrument can be replaced by the samemethod for a necessary number of times.

[0480] The following advantage can be demonstrated in this embodiment.That is, the guide wire 68 can be readily fixed by the guide wirefixture 69 by the operation of the operation lever 72 on the frontoperation portion 13 side of the endoscope 1 in this embodiment.

[0481] In addition, since the guide wire fixture 69 according to thisembodiment is formed by a snare-shaped wire which is opened in the loopform, secure fixation is enabled by snaring the snare-shaped wire of theguide wire fixture 69 when operating the operation lever 72.

[0482] Additionally, in an usual case, accommodating the guide wirefixture 69 in the end opening portion 71 a of the tow wire channel 71can prevent the guide wire fixture 69 from entering the observationvisual field of the endoscope 1. Thus, this causes no problems.

[0483] Further, in this embodiment, the protrusion 70 is provided on theend side away from the channel opening portion 26 of the end portion 17in the endoscope 1, and the guide wire fixture 69 can be temporarilyfixed to this protrusion. Therefore, as shown in FIG. 46A, the wire ofthe guide wire fixture 69 can be stably opened in the loop form at theprotrusion position where the guide wire fixture 69 is caused toprotrude at the upper surface position of the channel opening portion 26from the end opening portion 71 a of the tow wire channel 71.

[0484] Incidentally, although this embodiment has illustrated thestructure for effecting the towing operation of the tow wire 75 by theoperation lever 72 of the operation portion 13 through the linkmechanism as an example of the operation of the guide wire fixture 69,the present invention is not restricted thereto. Any other means may beused if the guide wire fixture 69 can be led in the axial direction ofthe insertion portion 12 of the endoscope 1. For example, an operatormanually tows a part of the tow wire 75 of the guide wire fixture 69protruding from the operation portion 13 to the outer side.

[0485] Furthermore, FIGS. 47A and 47B show a 25th embodiment accordingto the present invention. In this embodiment, the structure is changedso that a guide wire fixture 73 having a hook-like guide wire engagementportion 73 a is provided as shown in FIGS. 47A and 47B in place of thesnare-shaped wire which is opened in the loop form as in the guide wirefixture 69 according to the 24th embodiment.

[0486] The end portion of the tow wire 75 according to the 24thembodiment is fixed to the base end portion of the guide wire fixture73. Moreover, a guide wire engagement portion 73 a is formed at the endportion of the guide wire fixture 73.

[0487] The effect of this embodiment will now be described. In an usualcase when using the endoscope 1 according to this embodiment, the guidewire fixture 73 is towed to the front side by the operation lever 72 andaccommodated in the end opening portion 71 a of the tow wire channel 71.

[0488] In addition, when fixing the guide wire 68, the operation lever72 is used to cause the guide wire fixture 73 to protrude from the endopening portion 71 a of the tow wire channel 71 as shown in FIG. 47A.Then, the guide wire engagement portion 73 a of the guide wire fixture73 is hooked on the guide wire 68. Subsequently, in this state, theoperation lever 72 is used to tow the guide wire fixture 73 toward thefront side. As a result, as shown in FIG. 47B, the guide wire 68 led tothe outer side from the channel opening portion 26 is pressed againstthe edge part of the channel opening portion 26 on the rear end portionside and mechanically fixed by the guide wire engagement portion 73 a ofthe guide wire fixture 73.

[0489] In this embodiment, the following advantage can be demonstrated.That is, as in the 24th embodiment, the guide wire 68 can be also easilyfixed using the guide wire fixture 73 by the manipulation by theoperation lever 72 on the front operation portion 13 side of theendoscope 1 in this embodiment, and the advantage similar to that of the24th embodiment can be obtained.

[0490] Further, in this embodiment in particular, since the guide wirefixture 73 including the guide wire engagement portion 73 a having ahook shape is provided, it is not necessary to set the state in whichthe loop-like opening portion formed by the wire of the guide wirefixture 69 is opened as in the 24th embodiment when inserting the guidecatheter 67 into the therapeutic instrument insertion channel 23 fromthe insertion opening portion 61 of the operation portion 13 of theendoscope 1. Therefore, the guide wire 68 can be readily fixed by themanipulation of the operation lever 72 on the front side only whenfixing the guide wire 68, and hence the operability of the endoscope 1can be further improved.

[0491] Furthermore, FIGS. 48 to 50 show a 26th embodiment according tothe present invention. In this embodiment, the structure of the endportion 17 of the endoscope 1 according to the 25th embodiment ischanged as follows.

[0492] That is, in this embodiment, as shown in FIG. 48, the end openingportion 71 a of the tow wire channel 71 is provided on the end portionside away from the channel opening portion 26 in the notch portion 17 aof the end portion 17 in the endoscope 1, and the guide wire fixture 73according to the 25th embodiment is caused to protrude from the endopening portion 71 a on the end portion side away from the channelopening portion 26.

[0493] Moreover, to the end hard portion 21 is formed the tow wirechannel 71 which is bent into the substantially L shape along the lowersurface side and the left end portion (end portion) in the accommodationchamber 25 of the therapeutic instrument elevator base 27 in FIG. 49 andFIG. 50. In addition, the end opening portion 71 a of the tow wirechannel 71 is arranged on the notched surface of the notch portion 17 aof the end portion 17.

[0494] Additionally, the guide wire fixture 73 having a hook shapeaccording to the 25th embodiment is inserted into the tow wire channel71. The base end portion of the guide wire fixture 73 is led to theoperation portion 13 side as in the 24th embodiment and connected to theoperation lever 72 through the link mechanism. Since this link mechanismhas the same structure as the above-described elevator base actuationmechanism 41, its explanation is omitted.

[0495] The effect of this embodiment will now be described. In theendoscope 1 according to this embodiment, the guide wire fixture 73having a hook shape protrudes from the end opening portion 71 a on theend portion side away from the channel opening portion 26 in the notchportion 17 a of the end portion 17 in the endoscope 1 at the time ofmanipulation of the operation lever 72.

[0496] Further, with the guide wire engagement portion 73 a of the guidewire fixture 73 being hitched to the guide wire 68, by towing the guidewire fixture 73 to the front side by the operation lever 72, the guidewire 68 led to the outer side from the channel opening portion 26 can bepressed against the edge portion side of the end opening portion 71 a onthe end portion side away from the channel opening portion 26 andmechanically fixed by the guide wire engagement portion 73 a of theguide wire fixture 73 as shown in FIG. 50.

[0497] Furthermore, in this embodiment, as shown in FIG. 50, with theguide wire 68 being hooked by the guide wire engagement portion 73 a ofthe guide wire fixture 73, by raising the therapeutic instrumentelevator base 27, the tension from the guide wire fixture 73 and thethrusting force from the therapeutic instrument elevator base 27 act onthe guide wire 68 in the opposed directions in the shearing manner.Therefore, upon receiving the force in the opposed directions, the guidewire 68 is bent in to the substantially L shape, and the guide wire 68can be hence firmly fixed to the end portion 17 of the endoscope 1.

[0498] In this embodiment, as in the first and 25th embodiments, theguide wire 68 can be easily fixed using the guide wire fixture 73 by themanipulation of the operation lever 72 on the front operation portion 13side of the endoscope 1, and the advantage similar to that of the 24thembodiment can be obtained.

[0499] Moreover, in this embodiment in particular, since the end openingportion 71 a of the tow wire channel 71 is provided on the end portionside away from the channel opening portion 26 in the notch portion 17 aof the end portion 17 of the endoscope 1, the tension from the guidewire fixture 73 and the thrusting force from the therapeutic instrumentelevator base 27 can act on the guide wire 68 in the opposed directionsin the shearing manner by raising the therapeutic instrument elevatorbase with the guide wire 68 being hooked by the guide wire engagementportion 73 a of the guide wire fixture 73. Therefore, upon receiving theforce in the opposed directions, the guide wire 68 can be bent in to thesubstantially L shape and firmly fixed in this state. Accordingly, thereis the advantage that the guide wire 68 can be further securely fixed tothe end portion 17 of the endoscope 1 as compared with the case wherethe guide wire fixture 73 having a hook shape is caused to protrude fromthe front side of the channel opening portion 26 as in the 25thembodiment.

[0500] In addition, FIG. 52 and FIGS. 54A to 54B show a 27th embodimentaccording to the present invention. In this embodiment, a guide wireengagement member 422 having a hook shape which is driven to rotate by arotary operation mechanism 421 formed by rack and pinion gears isprovided in place of the guide wire engagement portion 73 a having ahook shape in the guide wire fixture 73 which is driven to move forwardand backward along the towing direction of the two wire 75 as in the25th embodiment.

[0501] As shown in FIG. 54A, a guide wire engagement portion 424 havinga hook shape is provided at the end portion of an elongated arm portion423 in the guide wire engagement member 422. Further, a pinion gear 425is provided to the base end portion of the arm portion 423.

[0502] Furthermore, as shown in FIG. 54B, a rack gear 426 is fixed tothe end portion of the tow wire 75 according to the 25th embodiment. Therack gear 426 of the tow wire 75 is meshed with the pinion gear 425 ofthe guide wire engagement member 422 as shown in FIG. 52. Moreover, therotary operation mechanism 421 consisting of rack and pinion gears isformed by the pinion gear 425 and the rack gear 426 of the guide wireengagement member 422.

[0503] In addition, as shown in FIG. 53, an engagement memberaccommodation chamber 428 for accommodating the guide wire engagementmember 422 is formed at the end opening portion 71 a of the tow wirechannel 71 in the end hard portion 21 of the endoscope 1.

[0504] It is to be noted that the end portion of the tow channel 71 isconnected to a connection pipe 71 b fitted in to a channel hole formedto the end hard portion 21. Further, a bearing portion 427 whichrotatably supports the pinion gear 425 of the guide wire engagementmember 422 is provided to the engagement member accommodation chamber428. Furthermore, the pinion gear 425 of the guide wire engagementmember 422 is rotatably supported by a support shaft 427 a (shown inFIG. 52) of the bearing portion 427.

[0505] The fixing position of the pinion gear 425 of the guide wireengagement member 422 is arranged on the side end of the engagementmember accommodation chamber 428 in such a manner that the guide wire 68which protrudes from the channel opening portion 26 of the end portion17 of the endoscope 1 can be grabbed by the guide wire engagementportion 424 having a hook shape.

[0506] The effect of this embodiment will now be described. In thisembodiment, the guide wire engagement member 422 is usually held at thestandby position that the guide wire engagement portion 424 having ahook shape is moved to the rear end portion of the channel openingportion 26 as indicted by solid lines in FIG. 52. Moreover, by pullingthe tow wire 75 to the front side by the manipulation of the operationlever 72 of the operation portion 13, the guide wire engagement member422 is driven to rotate by the rotary operation mechanism 421 consistingof the rack and the pinion. At this moment, when the guide wireengagement portion 424 having a hook shape cuts across the channelopening portion 26, the guide wire 68 is grabbed by the guide wireengagement portion 424 having a hook shape, and the guide wire 68 is ledto the direction of the side wall of the end hard portion 21. In thisstate, when the guide wire engagement member 422 further rotates, theguide wire 68 is held between the side wall of the end hard portion 21and the guide wire engagement portion 424, thereby fixing the guide wire68.

[0507] In addition, when releasing fixation of the guide wire 68, theguide wire engagement member 422 rotates in the opposite direction byreturning the operation lever 72 of the operation portion 13 to itsoriginal position, and the guide wire engagement portion 424 having ahook shape returns to the standby position that the guide wireengagement portion 424 having a hook shape is moved to the rear endposition of the channel opening portion 26 as indicated by solid linesin FIG. 52. As a result, the guide wire 68 comes off the guide wireengagement portion 424 having a hook shape, and fixation of the guidewire 68 is released.

[0508] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, as in the 25th embodiment, the guide wire68 can be readily fixed by the guide wire engagement member 422 by themanipulation of the operation lever 72 on the front operation portion 13side of the endoscope 1, and the guide wire 68 does not have to begripped on the operation portion 13 side of the endoscope 1 as in theprior art. Therefore, the operation for replacing the therapeuticinstrument is facilitated, and the operation time required for replacingthe therapeutic instrument can be hence shortened.

[0509] In addition, since the guide wire engagement member 422 includingthe guide wire engagement portion 424 having a hook shape is provided inthis embodiment, the guide wire 68 can be easily fixed by themanipulation of the operation lever 72 on the front side only whenfixing the guide wire 68. Therefore, the operability of the endoscope 1can be further enhanced.

[0510] Additionally, in this embodiment in particular, since theelongated arm portion 423 of the guide wire engagement member 422 is notdeeply pulled inside the end hard portion 21, the depth of theengagement member accommodation chamber 428 is reduced. Thus, abrush/cleaning fluid can easily spread inside the engagement memberaccommodation chamber 428 at the time of cleaning the endoscope 1, andthe operability during cleaning/sterilization can be improved.

[0511] Further, in case of guiding the guide wire 68 in the direction ofthe side wall of the end hard portion 21 by the guide wire engagementportion 424 having a hook shape, when the guide wire 68 enters thevisual field, it can be advantageously readily confirmed that the guidewire 68 is fixed.

[0512] It is to be noted that, as in a modification of the 27thembodiment illustrated in FIG. 55, the arm portion 423 of the guide wireengagement member 422 and the guide wire engagement portion 424 having ahook shape at the end portion of the arm portion 423 may be formed byseparate members and a friction reinforcement member 429 having thelarge friction resistance may be used for only the guide wire engagementportion 424 having a hook shape.

[0513] Furthermore, FIGS. 56A and 56B show a 28th embodiment accordingto the present invention. In this embodiment, the guide wire engagementmember 422 according to the 27th embodiment is changed as follows.

[0514] That is, in the guide wire engagement member 431 according tothis embodiment, as shown in FIG. 56B, a ring-like shaft fixing portion432 is provided to the base end portion of the arm portion 423 which issimilar to that of the guide wire engagement member 422 according to the27th embodiment. One end portion of the support shaft 433 is fixed tothe shaft fixing portion 432. A pinion gear 434 is fixed to the otherend portion of the support shaft 433. Moreover, an O ring 435 forsealing is fitted on the outer peripheral surface of the support shaft433 between the shaft fixing portion 432 and the pinion gear 434 of theguide wire engagement member 431.

[0515] In addition, as shown in FIG. 56A, a gear portion accommodationchamber 436 is additionally provided below the engagement memberaccommodation chamber 428 in the end hard portion 21 of the endoscope 1.Additionally, the shaft fixing portion 432 of the guide wire engagementmember 431 is accommodated in the engagement member accommodationchamber 428 and the pinion gear 434 is housed in the gear portionaccommodation chamber 436, respectively, in the end hard portion 21.Further, a sliding plane 637 coming in to contact with the O ring 435 isformed in the communication path between the engagement memberaccommodation chamber 428 and the gear portion accommodation chamber436. Furthermore, this O ring 435 assures the water-tightness betweenthe engagement member accommodation chamber 428 and the gear portionaccommodation chamber 436.

[0516] Moreover, the end portion of the channel hole of the tow wirechannel 71 which is formed at the end hard portion 21 is caused tocommunicate with the gear portion accommodation chamber 436. Inaddition, the rack gear 426 at the end portion of the tow wire 75 ismeshed with the pinion gear 434 in the gear portion accommodationchamber 436.

[0517] Additionally, the guide wire engagement member 431 according tothis embodiment is driven to rotate by the operation similar to that ofthe 27th embodiment through the meshed portion between the rack gear 426at the end portion of the tow wire 75 and the pinion gear 434 in thegear accommodation chamber 436.

[0518] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, as in the 27th embodiment, the guide wire68 can be readily fixed using the guide wire engagement member 431 bythe manipulation of the operation lever 72 on the front operationportion 13 side of the endoscope 1, and the guide wire 68 does not haveto be gripped on the operation portion 13 side of the endoscope 1 as inthe prior art. Therefore, since the operation for replacing thetherapeutic instrument is facilitated, there is the advantage that theoperation time required for replacing the therapeutic instrument can beshortened.

[0519] Further, in this embodiment, the gear portion accommodationchamber 436 is additionally provided below the engagement memberaccommodation chamber 428 in the end hard portion 21 of the endoscope 1,and the O ring 435 is used to assure the water-tightness between theengagement member accommodation chamber 428 and the gear portionaccommodation chamber 436. Therefore, dirt, etc does not enter the gearportion accommodation chamber 436 configured to have a complicated shapeand the tow wire channel 71. Thus, in addition to the advantage of the27th embodiment, there is the advantage that the cleaning/sterilizationproperty can be further improved.

[0520] Furthermore, FIGS. 57A, 57B and 57C show a 29th embodimentaccording to the present invention. In this embodiment, the end portion17 of the endoscope 1 according to the first embodiment is changed asfollows.

[0521] The structure of the end portion 17 of the endoscope 1 will nowbe described with reference to FIG. 57A. A guide wire fixing elevatorbase 26 is provided on the lower surface of the lead-in guide path 24 inthe end hard portion 21 at the end portion 17 of the endoscope 1. Oneend portion of the guide wire fixing elevator base 267 is pivoted withrespect to the end hard portion 21 by the elevator base swivelsupporting point 268. This elevator base swivel supporting point 268 isarranged at a lower part of the end opening portion of the lead-in guidepath 24. Moreover, the guide wire fixing elevator base 267 is attachedso as to be capable of a derricking motion in such a manner that itswivels around the elevator base swivel supporting point 268 from thestandby position indicated by solid lines in FIG. 57A to the set-upposition indicated by dotted lines in the same drawing in theintroduction guide path 24.

[0522] Moreover, the end portion of the tow wire 269 is fixed to theother end portion of the guide wire fixing elevator base 267 as shown inFIG. 57B. The tow wire 269 is led to the operation portion 13 throughthe tow wire channel 274.

[0523] In addition, a non-illustrated link mechanism for operating thetow wire 269 of the guide wire fixing elevator base 267 is included inthe operation portion 13. Since this link mechanism has the samestructure as the elevator base actuation mechanism 41, the explanationthereof is omitted. Additionally, the tow wire 269 is operated to betowed by manipulation of the operation lever 72 in the operation portion13 through the arm 49, the link member 44 and the wire mixing member 42,which have the link mechanism similar to the elevator base actuationmechanism 41, in sequence as in the therapeutic instrument elevator base27, and the derricking motion of the guide wire fixing elevator base 267is performed around the elevator base swivel supporting point 268. As aresult, as shown in FIG. 57C, the guide wire 68 which is inserted in tothe therapeutic instrument insertion channel 23 and led to the outerside from the channel opening portion 26 is fixed by raising the guidewire fixing elevator base 267.

[0524] It is to be noted that means for actuating the guide wire fixingelevator base is not restricted to this embodiment as long as it can towthe guide wire fixing elevator base 267.

[0525] Further, on the guide plane 275 of the guide wire fixing elevatorbase 267, steps are reduced as much as possible so that the channel 23and the guide plane 29 of the therapeutic instrument elevator base 27can be smoothly connected when the guide wire fixing elevator base 267is lowered.

[0526] It is to be noted that, assuming that the length of the guidewire fixing elevator base 267 is L and the diameter of the lead-in guidepath 24 is D as shown in FIG. 57B, the dimensional relationship of theguide wire fixing elevator base 267 is set to “D≦L”.

[0527] The effect of this embodiment will now be described. When usingthe endoscope 1 according to this embodiment, the guide wire fixingelevator base 267 is held at the standby position shown in FIG. 57B inadvance.

[0528] In this state, the guide catheter 67 is inserted in to thetherapeutic instrument insertion channel 23 from the insertion openingportion 61 of the operation portion 13 in the endoscope 1. Then, theguide catheter 67 is caused to protrude to the outer side from thechannel opening portion 26 and inserted in to a pancreatic/hepatic duct(not shown) in the papillotomy manner. At this moment, since the guideplane 275 of the guide wire fixing elevator base 267, the channel 23 andthe therapeutic instrument elevator base 27 are smoothly connected toeach other, the guide catheter 67 can be inserted without being caught.

[0529] Thereafter, when replacing the currently used guide catheter 67with a therapeutic instrument which is subsequently used, the guide wire68 is first inserted from the mouth ring on the base end side of theguide catheter 67. Then, an observation image (endoscopic image) of theendoscope 1 is used to confirm that the end portion of the guide wire 68has entered the pancreatic/hepatic duct (not shown), and the base endside of the guide wire 68 is gripped by a hand in such a manner that theguide wire 68 can not move. Subsequently, the operation for pulling outthe guide catheter 67 is conducted in this state.

[0530] At this moment, after an endoscopic image is used to confirm thatthe guide catheter 67 has been pulled from a papilla (not shown), theguide catheter 67 is further pulled out. Then, with the end of the guidecatheter 67 being housed in the therapeutic instrument insertion channel23, the guide wire fixing elevator base 267 is swiveled to the set-upposition indicated by solid lines in FIG. 57A by towing the two wire 269using the operation lever 72. Consequently, as shown in FIG. 57C, theguide wire 68 led to the outer side from the channel opening portion 26is sandwiched between the upper surface 273 of the lead-in guide path 24of the end hard portion 21 and the guide wire fixing elevator base 267and mechanically fixed.

[0531] Furthermore, after confirming that the guide-wire 68 is fixed,the guide catheter 67 is completely pulled to the outside of thetherapeutic instrument insertion channel 23 from the operation portion13 side of the endoscope 1.

[0532] Then, a therapeutic instrument which is subsequently used isinserted from the base end portion side of the guide wire 68. At thismoment, with the guide wire 68 being used as a guide, the therapeuticinstrument is inserted in to the therapeutic instrument insertionchannel 23. Moreover, when the therapeutic instrument hustles againstthe guide wire fixing elevator base 267, fixation by the guide wirefixing elevator base 267 is released by manipulating the operation lever72, and the therapeutic instrument is inserted in to thepancreatic/hepatic duct (not shown).

[0533] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the guide wire 68 can be easily fixed byoperating the guide wire fixing elevator base 267 by using the operationlever 72 on the front operation portion 13 side of the endoscope 1. Inaddition, in case of fixing the guide wire 68, secure fixation isenabled by holding the operation lever 72 at the operation position.

[0534] Additionally, in an usual case, by setting down the guide wirefixing elevator base 267 to the standby position shown in FIG. 57B, thetherapeutic instrument can be inserted without any problem since theintroduction guide path 24 of the end hard portion 21 is opened.

[0535] Further, since conventional therapeutic instruments can be usedas they are in this embodiment, the excellent operability can bemaintained by using an operator's favorite therapeutic instrument.Therefore, the therapeutic instrument can be replaced in a shorter timewithout deteriorating the conventional method for operating thetherapeutic instrument or the operation sense.

[0536] Furthermore, since the guide wire 68 can be fixed by the guidewire fixing elevator base 267 at the end portion 17 of the insertionportion 12, the length of the guide wire 68 can be shortened.Accordingly, there is the advantage that rolling and handling of theguide wire 68 can be facilitated and a large working space is no longernecessary. Moreover, replacement of the therapeutic instrument can befacilitated and the number of assistants can be reduced, whichadvantageously leads to a decrease in the time of operation.

[0537] In addition, in order to increase the fixation strength by thefriction resistance on the guide wire contact surface of the guide wirefixing elevator base 267 in the endoscope 1 according to the 29thembodiment, an elastic member 276 may be provided to the guide wirefixing elevator base 267 as in the first modification shown in FIG. 59Aor a protrusion 277 may be provided on the guide wire contact surface ofthe guide wire fixing elevator base 267 as in the second modificationshown in FIG. 59 as long as insertion of the therapeutic instrument isnot interfered.

[0538] Additionally, FIGS. 58A to 58C show 30th embodiment according tothe present invention. In this embodiment, the structure of thetherapeutic instrument elevator base 27 and the guide wire fixingelevator base 267 in the endoscope 1 according to the 29th embodiment ischanged as follows.

[0539] That is, in this embodiment, as shown in FIG. 58A, a platy guidewire fixing elevator base 282 is provided so as to be superimposed onthe therapeutic instrument elevator base 281. As shown in FIG. 58B, inthe therapeutic instrument elevator base 281, an attachment concaveportion 284 of the guide wire fixing elevator base 282 is provided to aswiveling portion in the vicinity of the elevator base swivel supportingpoint 283.

[0540] Further, as shown in FIG. 58C, a bearing portion 285 is formed onone end side portion side of the guide wire fixing elevator base 282.This bearing portion 285 is inserted in to the concave portion 284 ofthe therapeutic instrument elevator base 281 so as to be capable ofswiveling. Furthermore, the swivel supporting point 286 of the guidewire fixing elevator base 282 is provided coaxially with the swivelsupporting point 283 of the therapeutic instrument elevator base 281.

[0541] It is to be noted that the swivel supporting point 286 of theguide wire fixing elevator base 282 and the swivel supporting point 283of the therapeutic instrument elevator base 281 may have different axes.

[0542] Moreover, the end portion of the tow wire 269 according to the29th embodiment is fixed to the side surface of the guide wire fixingelevator base 282. The tow wire 269 is led to the operation portion 13through the tow wire channel 274 and connected to a non-illustrated linkmechanism. In addition, the towing operation of the guide wire fixingelevator base 282 is enabled through the tow wire 269 by manipulatingthe operation lever 72 on the front side as in the 29th embodiment.

[0543] It is to be noted that an elastic member 276 shown in FIG. 59A ora protrusion 277 shown in FIG. 59B may be provided on the top face ofthe guide wire fixing elevator base 282 as in the 29th embodiment.

[0544] Additionally, in this embodiment, by towing the tow wire 269 bythe operation lever 72, the guide wire fixing elevator base 282 isswiveled to the set-up position. Consequently, the guide wire 68 whichis led to the outer side from the channel opening portion 26 issandwiched between the upper surface 273 of the lead-in guide path 24 ofthe end hard portion 21 and the guide wire fixing elevator base 282 andmechanically fixed.

[0545] The following advantage can be demonstrated in this embodiment.That is, the guide wire 68 can be also releasably fixed at the endportion 17 of the insertion portion 12 in the endoscope 1 by using theguide wire fixing elevator base 282 when the tow wire 269 is towed bythe operation lever 72, thereby obtaining the advantage similar to thatof the 29th embodiment. Further, in this embodiment in particular, sincea platy guide wire fixing elevator base 282 is provided so as to besuperimposed on the therapeutic instrument elevator base 281, a spacefor installing the guide wire fixing elevator base 282 does not have tobe solely provided, thereby further saving the space.

[0546] Furthermore, FIG. 60A and FIGS. 60B to 62 show a 31st embodimentaccording to the present invention. In this embodiment, the structure ofthe 29th embodiment is changed so that the guide wire fixing elevatorbase 267 is incorporated in the therapeutic instrument elevator base 27.

[0547] That is, as shown in FIGS. 61A and 61B, an opening portion 293for accommodating incorporated components is provided on the guide plane291 a of the therapeutic instrument elevator base 291 according to thisembodiment. In this opening portion 293 are housed a guide wire fixingelevator base 292 and an elevator base moving member 295 according tothis embodiment.

[0548] The elevator base swivel supporting point 294 of the guide wirefixing elevator base 292 is coaxially pivoted together with the swivelsupporting point 294 of the therapeutic instrument elevator base 291.

[0549] It is to be noted that the elevator base swivel supporting point294 of the guide wire fixing elevator base 292 may have an axisdifferent from that of the swivel supporting point 294 of thetherapeutic instrument elevator base 291.

[0550] Moreover, the elevator base moving member 295 is provided at aposition on the end side of the endoscope 1 away from the guide wirefixing elevator base 292. The end portion of the tow wire 269 accordingto the 29th embodiment is fixed to the elevator base moving member 295.The tow wire 269 is led to the operation portion 13 through the tow wirechannel 274 and connected to a non-illustrated link mechanism. Inaddition, as in the 29th embodiment, the towing operation of the towwire 269 can be effected by manipulating the operation lever 72 on thefront side.

[0551] It is to be noted that the elevator base moving member 295 isusually held at the standby position arranged ahead away from the guidewire fixing elevator base 292 as shown in FIG. 60A. In this state, theguide wire fixing elevator base 292 is held at the standby positionwhere the guide wire fixing elevator base 292 is lowered.

[0552] Additionally, when towing the elevator base moving member 295, asshown in FIG. 60B, the elevator base moving member 295 is configured tomove to the front side and pushes the guide wire fixing elevator base292. As a result, the guide wire fixing elevator base 292 swivels aroundthe elevator base swivel supporting point 294 and swivels to the set-upposition shown in FIG. 60B. At this moment, the guide wire fixingelevator base 292 is set to a height corresponding to the upper surface297 of the lead-in guide path 24 of the end hard portion 21.

[0553] It is to be noted that the guide planes 291 a and 298 aresmoothly connected to each other without making irregularities when thetherapeutic instrument elevator base 291 and the guide wire fixingelevator base 292 are lowered.

[0554] Further, an R bending portion 300 is formed by cutting the edgeof the back surface portion of the guide wire fixing elevator base 292so that the elevator base moving member 295 can easily move to the backsurface side of the guide wire fixing elevator base 292. Furthermore, inorder to reduce the friction resistance of the guide plane 298 of theguide wire fixing elevator base 292, a material of the elevator basemoving member 295 may be changed from metal to plastic.

[0555] Moreover, in this embodiment, as shown in FIG. 62, therelationship between a set-up angle θ1 of the therapeutic instrumentelevator base 291 and an elevator base θ2 of the guide wire fixingelevator base 292 is set to “θ1<θ2”.

[0556] The effect of this embodiment will now be described. When usingthe endoscope 1 according to this embodiment, as in the 29th embodiment,with the guide catheter 67 being pulled in the lead-in guide path 24 orthe channel 23, the operation for raising the guide wire fixing elevatorbase 292 is performed. In such a case, in this embodiment, by towing theelevator base moving member 295 by using the operation lever 72, theelevator base moving member 295 moves below the guide wire fixingelevator base 292 and sets up the guide wire fixing elevator base 292.Then, the guide wire 68 is sandwiched between the guide wire fixingelevator base 292 and the upper surface 297 of the lead-in guide path 24of the end hard portion 21, and the guide wire 68 is fixed.

[0557] In this embodiment, since the guide wire fixing elevator base 292and the elevator base moving member 295 are accommodated in the openingportion 293 of the therapeutic instrument elevator base 291, theadvantage similar to that of the 30th embodiment can be obtained. Inaddition to the advantage of the 30th embodiment, the guide wire 68 canbe fixed by the guide wire fixing elevator base 292 which isdimensionally smaller than the therapeutic instrument elevator base 291since the relationship between the set-up angle θ1 of the therapeuticinstrument elevator base 291 and the set-up angle θ2 of the guide wirefixing elevator base 292 is set to “θ1<θ2” in this embodiment inparticular.

[0558] Further, as in the modification of the guide wire fixing elevatorbase 292 in the endoscope 1 according to the 31st embodiment shown inFIG. 63, a roller 299 may be provided on the back surface of the guidewire fixing elevator base 292 or the guide plane 298 of the elevatorbase moving member 295 so that the friction resistance between the backsurface of the guide wire fixing elevator base 292 and the guide plane298 of the elevator base moving member 295 can be reduced.

[0559] Furthermore, FIGS. 64 and 65 show a 32nd embodiment according tothe present invention. In this embodiment, a guide wire fixing elevatorbase 301 having a different structure is provided in place of the guidewire fixing elevator base 267 in the endoscope 1 according to the 29thembodiment.

[0560] That is, as shown in FIG. 64, at the end portion 17 of theinsertion portion 12 in the endoscope 1 according to this embodiment,the guide wire fixing elevator base 301 is provided on the rear end wallsurface 17 b of the notch portion 17 a. This guide wire fixing elevatorbase 301 is arranged at a part opposed to the therapeutic instrumentelevator base 27 in the channel opening portion 26.

[0561] Moreover, one end portion of the guide wire fixing elevator base301 is pivoted to the end hard portion 21 of the end portion 17 so as tobe capable of swiveling through a swivel supporting point 302. Inaddition, the end portion of the tow wire 303 is fixed on the other endside of the guide wire fixing elevator base 301. The base end portion ofthe tow wire 303 is led to the operation portion 13 and connected to anon-illustrated link mechanism. Additionally, the operation for towingthe guide wire fixing elevator base 301 is enabled by manipulation ofthe operation lever 72 on the front side through the tow wire 303 as inthe 29th embodiment.

[0562] It is to be noted that the elastic member 276 shown in FIG. 59Aor the protrusion 277 shown in FIG. 59B may be provided on a top face301 a of the guide wire fixing elevator base 301 as in the 29thembodiment.

[0563] The effect of this embodiment will now be described. In an usualcase, when the guide wire fixing elevator base 301 is pushed out by theoperation lever 72, the guide wire fixing elevator base 301 can swivelwith the guide wire fixing elevator base swivel supporting point 302 asa base point as indicated by a dotted line in FIG. 65, and insertion ofthe therapeutic instrument can be performed without any problem in anusual case.

[0564] Further, in this embodiment, the guide wire fixing elevator base301 is swiveled in a direction along which it comes in to contact withthe therapeutic instrument elevator base 27 side as indicated by solidlines in FIG. 65 by towing the two wire 303 by using the operation lever72. As a result, the guide wire 68 led from the channel opening portion26 to the outer side is sandwiched between the guide wire fixingelevator base 301 and the therapeutic instrument elevator base 27 andmechanically fixed, and the guide wire 68 can be fixed as in the 29thembodiment.

[0565] Since the guide wire 68 can be likewise fixed by the guide wirefixing elevator base 301 in this embodiment as in the 29th embodiment,the advantage similar to the 29th embodiment can be also obtained inthis embodiment.

[0566] Furthermore, FIGS. 66A to 66D show a 33rd embodiment according tothe present invention. In this embodiment, an operation mechanism forthe guide wire fixing elevator base 267, which has a differentstructure, is provided in place of the operation lever 72 for the guidewire fixing elevator base 267 in the operation portion 13 of theendoscope 1 according to the 29th embodiment.

[0567] That is, as shown in FIG. 66A, to the operation portion 13 of theendoscope 1 according to this embodiment is provided a tow knob 264 foroperation which is formed in to a substantially cylindrical shapebetween a grip 262 for holding the operation portion 13 and a bendprevention portion 263 below the insertion portion 61. This tow knob 264is rotatably fitted to the base 47 as a base board of the operationportion 13 as shown in FIG. 66C. Moreover, a rotary shaft 01 of the towknob 264 is coaxial with the central axis 02 of the insertion portion12.

[0568] Incidentally, the rotary shaft of the elevator operation knob 48of the therapeutic instrument elevator base 27 is coaxial with thecurved operation portion 56, and hence it exists orthogonally withrespect to the central shaft 02 of the insertion portion 12. Moreover,the rotary shaft 01 of the tow knob 264 exists at a position orthogonalto the rotary shaft of the elevator operation knob 48.

[0569] In addition, as shown in FIG. 66C, a cylindrical cam member 265is embedded in the two knob 264. As shown in FIG. 66D, a cam groove 265a is obliquely provided to this cam member 26S. A moving pin 266 isengaged with the cam groove 265 a of the cam member 265 so as to becapable of moving along the cam groove 265 a.

[0570] Additionally, the base end portion of the tow wire 269 insertedin to the tow wire channel 274 is fixed to the moving pin 266. When themoving pin 266 moves along the cam groove 265 a of the cam member 265with the rotating operation of the tow know 264, the two wire 269 movesforward/backward along the direction of the central axis 02 of theinsertion portion 12 through the moving pin 266.

[0571] The effect of this embodiment will now be described. When usingthe endoscope 1 according to this embodiment, if the guide wire fixingelevator base 267 is towed, the tow knob 264 is rotated. At this moment,since the cam member 265 also rotates integrally with the tow knob 264,the moving pin 266 moves in the cam groove 265 a with rotation of thecam member 265, and the guide wire fixing elevator base 267 is operatedto be towed by towing the tow wire 269.

[0572] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the guide wire 68 can be easily fixed atthe end portion 17 of the insertion portion 12 of the endoscope 1 by theoperation of the tow knob 264 on the front operation portion 13 side ofthe endoscope 1 as in the 29th embodiment, and the advantage similar tothat of the 29th embodiment can be obtained.

[0573] Additionally, in this embodiment in particular, since the rotaryshaft 01 of the tow knob 264 of the guide wire fixing elevator base 267exists at a position orthogonal to the rotary shaft of the elevatoroperation knob 48 of the therapeutic instrument elevator base 27, theoperation direction of the elevator operation knob 48 of the therapeuticinstrument elevator base 27 is different from the operation direction ofthe tow knob 264 of the guide wire fixing elevator base 267. Therefore,it is possible to prevent occurrence of an erroneous operation that theelevator operation knob 48 of the therapeutic instrument elevator base27 and the tow knob 267 of the guide wire fixing elevator base 267 aremixed up and actuated.

[0574] Further, since the insertion opening of the guide wire 68 and thetow knob 264 of the guide wire fixing elevator base 267 can get close toeach other by providing the tow knob 264 of the guide wire fixingelevator base 267 to a position in the vicinity to the insertion openingportion 61, the operability can be further improved.

[0575] It is to be noted that the tow knob 264 is not restricted to aposition between the bend prevention portion 263 below the insertionopening portion 61 and the grip 262. For example, as in the firstmodification of the operation portion 13 of the endoscope 1 according tothe 33rd embodiment shown in FIG. 67A it may be provided to theconnector-side bend prevention portion 14 a arranged at a connectionportion with the universal cord 14, the connector 18 or the grip 262.

[0576] Furthermore, the operating means of the guide wire fixingelevator base 267 is not restricted to a knob type, and it may be alever type using the operation lever 278 as in the second modificationof the operation portion 13 in the endoscope 1 shown in FIG. 67B. Atthis moment, although the link mechanism described in the 29thembodiment is the basis as the operation force transmission mechanism ofthe operation lever 278, the present invention is not restricted thereto if the towing operation is possible.

[0577] Moreover, FIGS. 66A and 66B show a 34th embodiment according tothe present invention. In this embodiment, a guide wire fixing mechanism361 having a different structure is provided in place of the guide wirefixing elevator base 267 according to the 29th embodiment.

[0578] That is, a substantially block-like guide wire fixture 362 isprovided to the guide wire fixing mechanism 361 according to the presentembodiment. In the end hard portion 21 at the end portion 17 of theinsertion portion 12 in the endoscope 1, an accommodation chamber 363 ofthe guide wire fixture 362 is provided on the upper surface of thelead-in guide path 24 communicating with the channel opening portion 26.A coil-like spring member 364 for giving impetus in the direction alongwhich the guide wire fixture 362 is pulled to the outside of theaccommodation chamber 363 in the substantially vertical direction isprovided in this accommodation chamber 363.

[0579] In addition, an end portion of the tow wire 365 is fixed to theguide wire fixture 362. The tow wire 365 is led to the operation portion13 through the tow wire channel 366 and connected to a non-illustratedlink mechanism. As a result, the towing operation of the guide wirefixture 362 is enabled through the tow wire 365 by the operation of theoperation lever 72 on the front side as in the 29th embodiment.

[0580] It is to be noted that an elastic member 276 shown in FIG. 59Aand a protrusion 277 shown in FIG. 59B may be provided on the contactsurface with the guide wire 68 in the guide wire fixture 362 as in the29th embodiment.

[0581] The effect of this embodiment will now be described. When usingthe endoscope 1 according to this embodiment, the tow wire 365 is pulledby the operation lever 72 in the initial state in advance, and the guidewire fixture 362 is drawn in to the accommodation chamber 363 as shownin FIG. 68A.

[0582] Then, as in the 29th embodiment, after the guide catheter 67 andthe guide wire 68 are inserted in to the body through the channel 23,the operation for loosening the tow wire 365 is carried out by themanipulation of the operation lever 72 with the guide catheter 67 beingpulled in to the channel 23. At this moment, the guide wire fixture 362is substantially vertically pulled to the outside of the accommodationchamber 363 by the elastic force of the spring member 364 and caused toprotrude in to the lead-in guide path 24 as shown in FIG. 68B. As aresult, the guide wire 68 is sandwiched between the end hard portion 21and the guide wire fixture 362 and mechanically fixed.

[0583] Additionally, after confirming that the guide wire 68 is fixed,the guide catheter 67 is completely pulled to the outside of thetherapeutic instrument insertion channel 23 from the operation portion13 side of the endoscope 1.

[0584] Thereafter, a therapeutic instrument which is subsequently usedis inserted from the base end portion side of the guide wire 68. At thismoment, with the guide wire 68 being used as a guide, the therapeuticinstrument is inserted in to the therapeutic instrument insertionchannel 23. Then, when the therapeutic instrument hustles against theguide wire fixture 362, the operation lever 72 is operated to releasefixation by the guide wire fixture 362 in order to further insert thetherapeutic instrument in to a pancreatic/hepatic duct (not shown).

[0585] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the guide wire 68 can be readily fixed bythe manipulation of the operation lever 72 of the front operationportion 13 in the endoscope 1, and the lead-in guide path 24 is openedby accommodating the guide wire fixture 362 in the accommodation chamber363 in a usual case. Therefore, the therapeutic instrument can beinserted without incident.

[0586] Further, since conventional therapeutic instruments can be usedin this embodiment, the excellent operability can be maintained by useof an operator's favorite therapeutic instrument. Furthermore, since theguide wire 68 can be fixed at the end portion 17 of the insertionportion 12 in the endoscope 1, the length of the guide wire 68 can beshortened as compared with a prior art, thereby improving theoperability.

[0587] Moreover, FIGS. 69A to 69C show a 35th embodiment according tothe present invention. In this embodiment, the structure is changed sothat a torque transmission member 371 is provided between the guide wirefixture 362 according to the 34th embodiment and the tow wire 365. Thistorque transmission member 371 is provided at the upper portion in theaccommodation chamber 363 of the end hard portion 21 provided at the endportion 17.

[0588] In addition, as shown in FIG. 69C, a rotary shaft 372 is providedin the vicinity of the center of the torque transmission member 371.Further, an end portion of the tow wire 365 is fixed to one end portionof the torque transmission member 371.

[0589] Furthermore, a slit-like opening portion 374 in to which thespring member 364 is inserted is provided on the opposite side to thefixing end 373 of the tow wire 365 in the torque transmission member371.

[0590] Moreover, a recess portion 375 for preventing interference withthe torque transmission member 371 during rotation of the torquetransmission member 371 is formed at the end hard portion 21 by scrapingaway the lower part of the rotary shaft 372.

[0591] The effect of this embodiment will now be described. When usingthe endoscope 1 of this embodiment, the torque transmission member 371is previously arranged so as to be substantially parallel to the lead-inguide path 24 in the initial state as shown in FIG. 69A. As a result,since the spring member 364 has a natural length, the guide wire fixture362 is accommodated in the accommodation chamber 363.

[0592] In addition, as in the 29th embodiment, after the guide catheter67 and the guide wire 68 are inserted in to the body through the channel23, the operation for towing the tow wire 365 is performed by themanipulation of the operation lever 72 with the guide catheter 67 beingpulled in to the channel 23. At this moment, one end of the torquetransmission member 371 is pulled by the tow wire 365 and moves upwardsand, at the same time, the other end moves downward.

[0593] Consequently, the guide wire fixture 362 is substantiallyvertically pulled to the outside of the accommodation chamber 363 andcaused to protrude to the inside of the lead-in guide path 24 as shownin FIG. 69B. As a result, the guide wire 68 is sandwiched between theend hard portion 21 and the guide wire fixture 362 and mechanicallyfixed.

[0594] Additionally, when releasing fixation of the guide wire 68, thetorque transmission member 371 returns to its original position byreturning the operation lever 72 to its original position, and the guidewire fixture 362 also returns to the accommodation chamber 36 by theresilience of the spring member 364, thereby releasing fixation of theguide wire 68.

[0595] In this embodiment, the following advantage can be demonstrated.That is, in this embodiment, the guide wire 68 can be readily fixed bythe manipulation of the operation lever 72 of the front operationportion 13 of the endoscope 1 as in the 34th embodiment, and the lead-inguide path 24 is opened by accommodating the guide wire fixture 362 inthe accommodation chamber 363 in an usual case. Thus, the therapeuticinstrument can be inserted without incidence.

[0596] Also, in this embodiment, in addition to the advantage similar tothat of the 34th embodiment, since the towing state by the operationlever 72 can be maintained at the time of fixing the guide wire 68, thestrong force can be applied to the guide wire fixture 362 through thetorque transmission member 371.

[0597] Further, FIGS. 70A to 70C show a 36th embodiment according to thepresent invention. In this embodiment, the guide wire fixing mechanism311 having a different structure is provided in place of the guide wirefixing elevator base 267 according to the 29th embodiment.

[0598] That is, as shown in FIG. 70A, a platy guide wire fixing member312 which can be elastically deformed is provided to the guide wirefixing mechanism 311 according to this embodiment. In the end hardportion 21 at the end portion 17 of the insertion portion 12 in theendoscope 1, an accommodation chamber 313 of the guide wire fixingmember 312 is provided on the upper surface of the lead-in guide path 24communicating with the channel opening portion 26. A coil-like springmember 314 for giving impetus in the direction along which the guidewire fixing member 312 is pulled in to the accommodation chamber 313 isprovided in this accommodation chamber 313.

[0599] The end portion of the tow wire 315 is fixed to the guide wirefixing member 312.

[0600] Furthermore, a guide roller 316 which is rotatable below theaccommodation chamber 313 on the lower surface of the lead-in guide path24 is provide to the end hard portion 21. Moreover, the tow wire 315running out toward the lower part of the accommodation chamber 313 isled to the operation portion 13 side in the state that it is bent towardthe operation portion 13 side by the guide roller 316, and connected tothe non-illustrated link mechanism. As a result, as in the 29thembodiment, the towing operation of the guide wire fixing member 312 isenabled through the tow wire 315 by the manipulation of the operationlever 72 on the front side.

[0601] Incidentally, although the above-described link mechanism is thebasis as the towing mechanism for the guide wire fixing member 312, thepresent invention is not restricted there to as long as the guide wirefixing member 312 can be towed.

[0602] The effect of this embodiment will now be described. When usingthe endoscope 1 according to this embodiment, as in the 29th embodiment,after the guide catheter 67 and the guide wire 68 are inserted in to thebody through the channel 23, the operation for towing the guide wirefixing member 312 is carried out through the tow wire 315 by themanipulation of the operation lever 72 with the guide catheter 67 beingpulled in to the lead-in guide path 24 or the channel 23. At thismoment, the guide wire fixing member 312 is pulled out from theaccommodation chamber 313, and the lower end portion of the guide wirefixing member 312 is brought in to contact with the lower surface of thelead-in guide path 24 of the end hard portion 12 as shown in FIG. 70C.As a result, the guide wire 68 is fixed by sandwiching the guide wire 68between the lower surface of the lead-in guide path 24 of the end hardportion 21 and the guide wire fixing member 312.

[0603] In addition, when the operation lever 72 is returned to itsoriginal position, the guide wire fixing member 312 is returned to thestate that it is pulled in to the accommodation chamber 313 by theresilience of the spring member 314. Consequently, the lower end portionof the guide wire fixing member 312 moves away from the guide wire 68,and fixation of the guide wire 68 is hence released.

[0604] In this embodiment, the guide wire fixing member 312 is subjectedto the towing operation through the tow wire 315 by the manipulation ofthe operation lever 72, and the guide wire 68 can be releasably fixed atthe end portion 17 of the insertion portion 12 of the endoscope 1 by theguide wire fixing member 312, thereby obtaining the advantage similar tothe 29th embodiment. In addition to the advantage of the 29thembodiment, there is an advantage that the guide wire fixing member 312does not interfere with a case when the guide wire fixing member 312 isaccommodated in the accommodation chamber 313 of the end portion 17 incase of releasing fixation of the guide wire 68 in this embodiment inparticular.

[0605] Additionally, FIGS. 71 and 72 show a 37th embodiment according tothe present invention. In this embodiment, the structure of the endportion 17 of the endoscope 1 according to the 24th embodiment ischanged as follows.

[0606] That is, in this embodiment, a wire-type guide wire fixture 81which is curved in to a substantially U shape is provided at the endportion of the tow wire 75 according to the 24th embodiment as shown inFIG. 71, and the end portion of the guide wire fixture 81 is fixed onthe side surface of the channel opening portion 26 in the notch portion17 a at the end portion 17 in the endoscope 1. A method for fixing theguide wire fixture 81 to the end portion 17 is adhesion, soldering,screwing and others.

[0607] The effect of this embodiment will now be described. When usingthe endoscope 1 according to this embodiment, the guide wire fixture 81is previously set in the extended state so as to surround the channelopening portion 26 as shown in FIG. 71.

[0608] Then, as in the 24th embodiment, after the guide wire 68 and theguide catheter 67 are inserted in to the therapeutic instrumentinsertion channel 23, the guide catheter 67 is pulled to the inside ofthe channel 23 and only the guide wire 68 is caused to protrude to theoutside of the channel opening portion 26 in case of fixing the guidewire 68. In this state, the operation for pulling the guide wire fixture81 to the front side is carried out by the manipulation of the operationlever 72 on the front side. As a result, as shown in FIG. 72, the guidewire 68 is sandwiched between the front side wall surface 26 a of thechannel opening portion 26 and the guide wire fixture 81 as shown inFIG. 72, and the guide wire 68 is fixed.

[0609] In this embodiment, the guide wire 68 can be easily fixed by theguide wire fixture 81 at the end portion of the tow wire 75 bymanipulating the operation lever 72 on the front operation portion 13side in the endoscope 1 as in the 24th embodiment, thereby obtaining theadvantage similar to that of the 24th embodiment.

[0610] Also, in this embodiment in particular, besides the advantage ofthe 24th embodiment, the guide wire fixture 81 is formed by only fixingthe end portion of the tow wire 75 as the operating means on the sidesurface of the channel opening portion 26 in the notch portion 17 a ofthe end portion 17 in the endoscope 1, which is inexpensive.

[0611] Further, FIG. 73 shows a modification of the tow wire 75 which isin the fixed state at the end portion of the guide wire fixture 81 inthe endoscope 1 according to the 37th embodiment.

[0612] In this modification, as shown in FIG. 73, a plate material 82 isfixed to the end portion of the guide wire fixture 81 by solder and thelike, and the plate material 82 is connected to the end portion 17 ofthe endoscope 1 by a pin 83 and the like so as to be capable ofswiveling.

[0613] Furthermore, as in the 24th embodiment, a protrusion 70 by whichthe guide wire fixture 81 can be temporarily fixed in the extended statemay be provided to the notch portion 17 a of the end portion 17 in theendoscope 1 on the end side away from the channel opening portion 26.

[0614] Thus, in this modification, the plate material 82 is fixed to theguide wire fixture 81, and the plate material 82 is connected to the endportion 17 of the endoscope 1 by the pin 83 and the like so as to becapable of swiveling. Therefore, there is an advantage that the loadacting on the guide wire fixture 81 can be reduced when operating theguide wire fixture 81.

[0615] Moreover, FIGS. 74A to 74C show a 38th embodiment according tothe present invention. In this embodiment, the structure of the endportion 17 of the endoscope 1 according to the 24th embodiment ischanged as follows.

[0616] That is, in this embodiment, as shown in FIGS. 74A and 74B, aguide wire fixture 91 which is a member different from the tow wire 75is connected to the end portion of the tow wire 75 according to the 24thembodiment.

[0617] The guide wire fixing plane of this guide wire fixture 91 mayhave a circular shape, a planar shape or a irregular shape according tothe wire diameter of the guide wire 68. In addition, the end portion ofthe tow wire 75 is fixed to one end portion of the guide wire fixture91. Additionally, a guiding protrusion 92 is provide to the other endportion of the guide wire fixture 91 so as to protrude therefrom.

[0618] Further, as shown in FIG. 74C, a guide groove 93 for guidingmovement of the guide wire fixture 91 extends on the side surfaceportion of the accommodation chamber 25 of the end hard portion 21 alongthe axial direction of the insertion portion 12 of the endoscope 1. Theguiding protrusion 92 of the guide wire fixture 91 is engaged with theguide groove 93. Furthermore, in the state that the guiding protrusion92 slides along the guide groove 93 with the operation of the tow wire75, the guide wire fixture 91 is moved along the axial direction of theinsertion portion 12 of the endoscope 1.

[0619] Moreover, a range of movement of the guide wire fixture 91 by theoperation of the tow wire 75 is set from the front side wall surface 26a of the channel opening portion 26 to the end side away from thetherapeutic instrument elevator base 27.

[0620] The effect of this embodiment will now be described. In thisembodiment, before inserting the guide catheter 67, the guide wirefixture 91 is set in the state that it is thrusted to the end side ofthe end portion 17 of the endoscope 1 in advance.

[0621] Then, as in the 24th embodiment, after the guide wire 68 ad theguide catheter 67 are inserted in to the therapeutic instrumentinsertion channel 23, the guide catheter 67 is pulled to the inside ofthe channel 23 and only the guide wire 68 is caused to protrude to theoutside of the channel opening portion 26 in case of fixing the guidewire 68. In this state, the operation for pulling the guide wire fixture91 to the front side is carried out through the tow wire 75 by themanipulation of the operation lever 72 on the front side. As a result,the guide wire 68 is sandwiched between the front side wall surface 26 aof the channel opening portion 26 and the guide wire fixture 91, and theguide wire 68 is fixed.

[0622] In this embodiment, the guide wire 68 can be likewise easilyfixed by the guide wire fixture 91 at the end portion of the tow wire 75by manipulating the operation lever 72 on the front operation portion 13side in the endoscope 1 as in the 24th embodiment, and the advantagesimilar to that of the 24th embodiment can be obtained.

[0623] Also, in this embodiment in particular, the guide groove 93 isprovided on the side surface portion of the accommodation chamber 25 ofthe end hard portion 21, and the guiding protrusion 92 of the guide wirefixture 91 is engaged with the guide groove 93. Therefore, the guidewire fixture 91 does not move out from the channel opening portion 26,thereby enabling the stable operation for fixing the guide wire 68.

[0624] Further, as in the modification of the endoscope 1 in the 38thembodiment shown in FIG. 75, the tow wire 75 of the guide wire fixture91 may be provided on the upper surface portion of the end hard portion21 as long as the tow wire 75 does not enter the observation visualfield extending from the object lens 57.

[0625] Furthermore, FIGS. 76 to 80 show a 39th embodiment. In thisembodiment, the inner structure of the end portion 17 of the insertionportion 12 in the endoscope 1 according to the 24th embodiment ischanged as follows.

[0626] That is, in this embodiment, as shown in FIG. 78, a secondopening portion 561 is formed at the upper surface portion of thechannel opening 26 in the end hard portion 21. The base end portion ofthe second opening portion 561 is connected to the end portion of theguide wire fixture insertion channel 563 through a connection pipe 562fixed to the channel hole of the end hard portion 21. The base endportion of the guide wire fixture insertion channel 563 is connected toa second insertion mouth ring portion 564 provided to the operationportion 13 of the endoscope 1 as shown in FIG. 76.

[0627] It is to be noted that the opening position of the guide wirefixation insertion channel 563 on the front side is not restricted tothe position of the second insertion mouth ring portion 564 of theoperation portion 13 shown in FIG. 76, and it may be set anywhere aslong as that position can facilitate the fixing operation.

[0628] Moreover, the guide wire fixture 565 which performs the operationfor fixing the guide wire 68 is configured to be removably inserted into the guide wire fixture insertion channel 563. The guide wire fixture565 is constituted by assembling three components, i.e., a snare unit566, an elastic member 567 such as a coil spring, and an exterior unit568 shown in FIG. 80.

[0629] In the snare unit 566, an end member 570 on the front side isconnected to the base end portion of the elongated tow wire 569. The endmember 570 is formed by a two-stage columnar member to which a columnargripping portion 571 having a large diameter and a second columnarportion 572 having a small diameter are connected.

[0630] In addition, an engagement protrusion 573 is provided to thesecond columnar portion 572 of the end member 570, and an elastic memberstopper 574 is provide to the step portion, respectively.

[0631] Additionally, an index 575 by which a rotation position can beconfirmed is provided to one side portion of the gripping portion 571 ofthe end member 570.

[0632] Further, a loop-shaped snare 576 is provided to the end portionof the tow wire 569.

[0633] It is to be noted that the end portion of the tow wire 569 is notrestricted to the snare 576 and it may have a hook shape which can hookand catch the guide wire 68.

[0634] Furthermore, a soft tube 578 for guiding the tow wire 569 of thesnare unit 566 is provided to the exterior unit 568. A fixing member 579which is releasably engaged with the end member 570 of the snare unit566 is provided to the base end portion of the soft tube 578.

[0635] To the fixing member 579 are provided a mouth ring pressuremember 580 which can be attached to the second insertion mouth ringportion 564, and a cylindrical member 581 which protrudes on the uppersurface of the mouth ring pressure member 580. Moreover, an L-shapedengagement groove 582 is formed at the cylindrical member 581. Anengagement protrusion 573 of the snare unit 566 can be engaged with theengagement groove 582.

[0636] In addition, a second s topper 583 is provided to the lowerportion of the cylindrical member 581.

[0637] Additionally, the guide wire fixture 565 is integrally assembledby inserting the snare unit 566 in to the cylindrical member 581 of theexterior unit 568 through the elastic member 567 such as a coil spring.At this moment, the elastic member 567 is arranged between the elasticmember s topper 574 of the snare unit 566 and the second s topper 583 ofthe exterior unit 568 and set in the state that the engagementprotrusion 573 of the snare unit 566 is inserted in the engagementgroove 582 of the cylindrical member 581.

[0638] It is to be noted that the guide wire fixture 565 according tothis embodiment may be substituted by a snare or a gripping therapeuticinstrument which is usually used as a therapeutic instrument.

[0639] The effect of this embodiment will now be described. Usually, asshown in FIG. 79B, the impetus in the direction along which theengagement protrusion 573 of the snare unit 566 hustles against the endportion of the engagement groove 582 on the opening end side (start endportion 582 a) acts on the guide wire fixture 565 according to thisembodiment by the elastic force of the elastic member 567, and theposition of the snare unit 566 is restricted in this state. In such astate, the gripping portion 571 of the snare unit 566 is caused toprotrude to the outer side of the cylindrical member 581 of the exteriorunit 568 and held in this state, and the snare 576 is held in the closedstate.

[0640] Further, when opening the snare 576, the gripping portion 571 ofthe snare unit 566 is operated to be pushed to the inner side of thecylindrical member 581 of the exterior unit 568 against the elasticforce of the elastic member 567. With this operation, the engagementprotrusion 573 of the snare unit 566 slides in the axial direction alongthe engagement groove 582 and moves to the position at which it isbrought in to contact with the end portion of the engagement groove 582on the mouth ring pressure member 580 side. In this state, the snare 576protrudes from the soft tube 578 as shown in FIG. 79A, and the snare 576is opened.

[0641] Subsequently, the gripping portion 571 is swiveled in thecounterclockwise direction at this position, and the engagementprotrusion 573 is brought in to contact with the engagement end portion582 b at the dead end of the engagement groove 582 as shown in FIG. 79A.As a result, the engagement protrusion 573 can be engaged, and the snare576 can be held in the opened state.

[0642] Furthermore, when closing the snare 576, the engagementprotrusion 573 comes off the engagement end portion 582 b at the deadend of the engagement groove 582 by rotating the gripping portion 571 inthe clockwise direction, and the snare unit 566 returns to its originalposition shown in FIG. 79B by the elastic force of the elastic member567.

[0643] Description will now be given as to the method for fixing theguide wire 68 to the end portion 17 of the insertion portion 12 by usingthe guide wire fixture 566 according to this embodiment. The endoscope 1is first inserted in to the body. Then, when a papilla is captured bythe end portion 17 of the insertion portion 12, the guide wire fixture565 is inserted from the second insertion mouth ring portion 564 withthe snare 576 being closed. Thereafter, when the end of the guide wirefixture 565 protrudes from the second opening portion 561, the snare 576is caused to protrude as shown in FIG. 77B by pushing the grippingportion 571. The subsequent operation is similar to that of the guidewire fixture 69 according to the 24th embodiment.

[0644] The following advantage can be demonstrated in this embodiment.That is, the advantage similar to that of the 24th embodiment can beobtained in this embodiment. In addition to this, since the guide wirefixture 565 can be easily removed from the endoscope 1, the end portion17, the inside of the guide wire fixture insertion channel 563 and theguide wire fixture 565 can be readily cleaned/sterilized.

[0645] Moreover, there is an advantage that the inner structure of theend portion 17 of the insertion portion 12 in the endoscope 1 can besimplified.

[0646] In addition, the existing snare, the therapeutic instrument forgripping and others can substitute the guide wire fixture 565. Also,when the guide wire fixture 565 is not used, the guide wire fixtureinsertion channel 563 can be used as the treatment channel or the frontwater supply duct.

[0647] A 40th embodiment according to the present invention will now bedescribed with reference to FIGS. 81 to 85. FIG. 81 shows a schematicstructure in an end portion 603 of an insertion portion 602 of anendoscope 601 in an endoscope apparatus according to this embodiment. Inthe endoscope apparatus according to this embodiment, there is used aside viewing type endoscope 601 for observing a direction substantiallyorthogonal to the axial direction of the insertion portion 602.

[0648] To the side viewing type endoscope 601 is formed a substantiallyplanar side viewing reference plane 612 which is formed by notching theouter peripheral surface of the end portion 603 of the insertion portion602. An illumination window 613 of an illumination optical system and anobservation window 614 of an observation optical system are aligned onthe side viewing reference plane 612 in the front-and-back direction.Additionally, a channel opening portion 615 is provided next thealignment portion of the illumination window 613 and the observationwindow 614 on the side viewing reference plane 612. This channel openingportion 615 constitutes the end opening portion of the therapeuticinstrument insertion channel 616 provided in the insertion portion 602of the endoscope 601.

[0649] Further, a therapeutic instrument elevator base 617 is providedto the channel opening portion 615. As shown in FIG. 85, one end portionof the therapeutic instrument elevator base 617 is connected to a mainbody 611 a of the end portion 603 through a swiveling shaft 618 so as tobe capable of swiveling without restraint.

[0650] Furthermore, one end portion of a non-illustrated flexibleoperation wire is fixed to the other end portion of the therapeuticinstrument elevator base 617. The other end portion of the operationwire is extended to an operation portion 606 side. Moreover, theoperation wire is towed in cooperation with manipulation of anon-illustrated therapeutic instrument elevator base operation leverprovided to the operation portion 606, and the operation of thisoperation wire drives the therapeutic instrument elevator base 617 toswivel around the swiveling shat 618. At this moment, the therapeuticinstrument elevator base 617 is caused to swivel from a standby position(set-down position) indicated by dotted lines in FIG. 85 to a maximumswivel position (set-up position) indicated by solid lines in FIG. 85,and each of the elevator operation and the set-down operation in atherapeutic instrument 619, for example, an contrasting tube shown inFIGS. 83A and 83B, which is extended from the channel opening portion615 to the outside is carried out in the visual field of the observationwindow 614 by the swiveling operation of the therapeutic instrumentelevator base 617.

[0651] Moreover, as the therapeutic instrument 619 inserted in to thetherapeutic instrument insertion channel 616 of the endoscope 601according to this embodiment, a therapeutic instrument such as anexisting contrasting tube provided with a guide wire lumen in to which alater-described guide wire 630 can be inserted can be used as it is.

[0652] Incidentally, the therapeutic instrument 619 which has astructure for reducing the frictional force with respect to the guidewire 630 or has the smoothed inner surface of the guide wire lumen byapplying coating to the guide wire lumen is further preferable in thisembodiment.

[0653] In addition, a substantially-V-shaped receiving groove portion 20is formed on the opposite surface to the therapeutic instrument 619 inthe therapeutic instrument elevator base 617. Additionally, when raisingthe therapeutic instrument 619, the therapeutic instrument 619 isbrought in to contact with the therapeutic instrument elevator base 617with the therapeutic instrument 619 being inserted in the receivinggroove portion 20 to be positioned, and the therapeutic instrument 619is guided in the vertical direction.

[0654] Further, in the side viewing type endoscope 601 according to thisembodiment, a guide wire fixing member 621 as guide wire fixing means isattached in the vicinity of the end portion 603 of the insertion portion602. To the guide wire fixing member 621 are provided a substantiallycylindrical soft attachment portion 622 which is formed of a materialsuch as chloroethene and a substantially cylindrical cap portion 623connected to the end side of the attachment portion 622.

[0655] Furthermore, a material of the attachment portion 622 does nothave to be necessarily chloroethene, and it may be polyethylene,polystyrene or polyurethane as long as it is a soft resin. Moreover,with the cap portion 623 being arranged around the end portion 603 ofthe insertion portion 602, the attachment portion 622 is attached in thevicinity of the end portion 603 of the insertion portion 602 in theendoscope 601. As a result, the guide wire fixing member 621 isdetachably attached on the channel opening portion 615 or the insertionportion 602 on the base end side away from the channel opening portion615 in the vicinity of the end portion 603 of the insertion portion 602in the endoscope 601.

[0656] In addition, the cap portion 623 is made of polycarbonate resinhaving the transparency. As to a color tone of the cap portion 623, onehaving the high transparency is preferable, but it does not have to benecessarily transparent.

[0657] Incidentally, in regard to a composition of a material of the capportion 623, polycarbonate resin is most preferable, but acrylic resin,polyethylene resin, polypropylene resin, polystyrene resin and otherscan be also used.

[0658] Further, on the end side of the cap portion 623 is formed atherapeutic instrument insertion opening window 624 at a positioncorresponding to the illumination window 613, the observation window 614and the channel opening portion 615 on the side viewing reference planeof the end portion 603. The therapeutic instrument insertion openingwindow 624 of the cap portion 623 is opened on the reference plane 612side of the insertion portion 602 of the endoscope 601. The openingwindow 624 is formed in to a substantially rectangular shape in such amanner that a width thereof is approximately ¼ of the circumference ofthe cap portion 623 whilst a length thereof is approximately 10 mm. As aresult, the visual field of the observation window 614 of the endoscope601 or the forward/backward movement of the therapeutic instrument 619such as a contrasting tube extended to the outer side from the channelopening portion 615 can not be obstructed, and later-described guidewire identification members 627 a and 627 b can be easily actuated.Also, a later-described guide wire fixture insertion hole 628 can bearranged at an effective position.

[0659] Furthermore, a guide wire identification mechanism portion 625and a guide wire fixing mechanism 626 are provided to the therapeuticinstrument insertion opening window 624 of the cap portion 623. To theguide wire identification mechanism portion 625 are provided guide wireidentification members 627 a and 627 b which consist of two stainlesssteel wires projecting to the inner side of the opening window 624 fromthe both sides of the opening window 624.

[0660] Moreover, one of the two guide wire identification members 627 aand 627 b, i.e., the first guide wire identification member 627 a isextended from the left side of the therapeutic instrument insertionopening window 624 to the inner side along the upper edge portion of thecap portion 623 and curved downward in FIG. 82. In addition the othersecond guide wire identification member 627 b is extended from the rightside of the therapeutic instrument insertion opening window 624 to theinner side along the upper edge portion of the cap portion 623 andcurved downward in FIG. 82. Respective lower extended portions 627 a 1and 627 b 1 of the two guide wire identification members 627 a and 627 bare spaced from each other and oppositely arranged substantially inparallel along the direction of the center line of the guide wire fixingmember 621. A space S having an appropriate width dimension L is formedbetween the respective lower extended portions 627 a 1 and 627 b 1 ofthe guide wire identification members 627 a and 627 b. This space S isset so as to be larger than, e.g., the outside diameter dimension of theguide wire 630.

[0661] Additionally, guide wire fixture insertion holes 628 arerespectively formed to the both side portions of the therapeuticinstrument insertion opening window 624 in the cap portion 623. Theseguide wire fixture insertion holes 628 are arranged at a substantiallycentral position of the therapeutic instrument insertion opening window624 along the direction of the center line of the guide wire fixingmember 621.

[0662] Further, to the guide wire fixing mechanism portion 626 isprovided a guide wire fixture 629 formed of a filate member having noelastic property, e.g., a surgical suture having an outside diameterdimension of approximately 0.2 mm. One end portion of the guide wirefixture 629 is fixed to the first guide wire identification member 627 aon the left side in FIG. 82. Furthermore, the guide wire fixture 629passes through the guide wire fixture insertion hole 628 of thetherapeutic instrument insertion opening window 624 on the left side(first guide wire identification member 627 a side) in FIG. 82, thencuts across the opening window 624, and passes through the guide wirefixture insertion hole 628 on the right side (second guide wireidentification member 627 b side) in FIG. 82 so that the other endportion side of the guide wire fixture 629 is fixed to the second guidewire identification member 627 b. As a result, the guide wire fixture629 is attached so as to be spanned between the both side portions onthe opening window 624.

[0663] Incidentally, although the surgical suture having an outsidediameter dimension of approximately 0.2 mm is used as the guide wirefixture 629 in this embodiment, any other thread made of a resin such asnylon may be used as long as it is a pliable filate member which has noelastic property but the high tensile strength.

[0664] Moreover, the guide wire identification members 627 a and 627 bare not restricted to stainless steel wires, and a copper wire, anyother metallic wire made of, e.g., superelastic alloy manufactured byNiTi or a resin wire may be used as long as it is an elastic member.

[0665] Consequently, when the therapeutic instrument 619 is being drawnfrom the channel opening portion 615 on the end portion 603 side of theinsertion portion 602 in the endoscope 601, the guide wire fixingmechanism portion 626 does not obstruct the operation of the therapeuticinstrument 619. Also, when only the guide wire 630 is being drawn fromthe channel opening portion 615, the guide wire 630 is welded withpressure to and engaged with the guide wire fixture 629 between the bothside portions on the opening window 624 of the guide wire fixing member621 by the thrusting force from the therapeutic instrument elevator base617.

[0666] When the therapeutic instrument 619 is being pulled to theoperation portion front side by the guide wire fixing mechanism portion626 after being inserted in to the therapeutic instrument insertionchannel 616, a protruding length of the therapeutic instrument 619 whichis required for the operation is assured from the channel openingportion 615 as the operation portion front side opening of thetherapeutic instrument insertion channel 616.

[0667] In addition, when the guide wire 630 is inserted in to the guidewire lumen of the therapeutic instrument 619, a necessary protrudinglength of the guide wire 630 is provided from the end of the therapeuticinstrument 619 in accordance with a target portion, and a protrudinglength of the same which is required for the operation is assured fromthe rear end of the therapeutic instrument 619.

[0668] The protruding length from the end of the therapeutic instrument619 is approximately not more than 40 cm, and an protrusion amount ofapproximately 10 cm from the mouth ring 604 a provided on the base endside of the therapeutic instrument 619 can obtain the most excellentoperability and is ideal.

[0669] The effect of this embodiment will now be described. When usingthe endoscope apparatus according to this embodiment, if the therapeuticinstrument 619 such as a contrasting tube is inserted in to thetherapeutic instrument insertion channel 616 on the operation portion606 side of the endoscope 601 and used, the end portion of thetherapeutic instrument 619 is caused to protrude from the channelopening portion 615 of the end portion 603 of the insertion portion 602in the endoscope 601. At this moment, if the therapeutic instrumentelevator base 617 is held at a standby position (set-down position)indicated by dotted lines in FIG. 85, the end portion of the therapeuticinstrument 619 is moved away from the guide wire identification members627 a and 627 b of the guide wire identification mechanism portion 625and held at a freely movable position as shown in FIG. 83A.

[0670] In this state, by manipulating a non-illustrated therapeuticinstrument elevator base operation lever of the operation portion 606 ofthe endoscope 601, the therapeutic instrument elevator base 617 at theend portion 603 of the insertion portion 602 is operated to be raised.Then, the end portion of the therapeutic instrument 619 is pushed out inthe direction along which it is inserted in to the therapeuticinstrument insertion opening window 624 of the cap portion 623 by thetherapeutic instrument elevator base 617 with this operation.

[0671] At this moment, the therapeutic instrument 619 is insertedbetween the respective lower extended portions 627 a 1 and 627 b 1 ofthe two guide wire identification members 627 a and 627 b projectingfrom the both sides of the therapeutic instrument insertion openingwindow 624 of the cap portion 623. Therefore, the space between therespective lower extended portions 627 a 1 and 627 b 1 of the two guidewire identification members 627 a and 627 b is extended by thetherapeutic instrument 619, and the gap between the respective lowerextended portions 627 a 1 and 627 b 1 is widened. Consequently, when therespective guide wire identification members 627 a and 627 b move closeto the guide wire fixture insertion holes 628 on the both sides of thetherapeutic instrument insertion opening window 624, the tensile forceof the guide wire fixtures 629 respectively fixed to the respectiveguide wire identification members 627 a and 627 b is relaxed. As aresult of relaxing the tensile force of the guide wire fixture 629 inthis manner, when the end portion of the therapeutic instrument 619 ispushed out in the direction along which it is inserted in to thetherapeutic instrument insertion opening window 624 of the cap portion623 by the therapeutic instrument elevator base 617, the therapeuticinstrument 619 is not engaged by the guide wire fixture 629, and theoperation for raising the therapeutic instrument 619 is carried out asusual.

[0672] Additionally, if the therapeutic instrument elevator base 617 isheld at the standby position (set-down position) indicated by dottedlines in FIG. 85 when the end portion of the guide wire 630 is led outfrom the channel opening portion 615 of the endoscope 601, the guidewire 630 moves away from the guide wire fixture 629 as shown in FIG. 84Aand is held at a freely movable engagement releasing position.

[0673] When the therapeutic instrument elevator base 617 is swiveled toa maximum swiveling position (set-up position) indicated by solid linesin FIG. 85 in this state, the guide wire 630 is pushed out in thedirection along which it is inserted between the guide wireidentification members 627 a and 627 b of the guide wire identificationmechanism portion 625 by the therapeutic instrument elevator base 617 asshown in FIG. 84B. At this moment, since the space S between therespective lower extended portions 627 a 1 and 27 b 1 of the guide wireidentification members 627 a and 627 b is larger than, e.g., the outsidediameter dimension of the guide wire 630, the space S between the twolower extended portions 627 a 1 and 627 b 1 is not widened by the guidewire 630 inserted between the respective lower extended portions 627 a 1and 627 b 1 of the guide wire identification members 627 a and 627 b,and the tensile force of the guide wire fixture 629 spanned between theboth side portions over the opening window 624 of the guide wire fixingmember 621 is not relaxed.

[0674] In this case, with the operation by which the therapeuticinstrument elevator base 617 of the end portion 603 of the insertionportion 602 is raised by manipulation of the non-illustrated therapeuticinstrument elevator base operation lever, the guide wire 630 is weldedwith pressure to the guide wire fixture 629 between the both sideportions over the opening window 624 in the guide wire fixing member 621by the thrusting force from the therapeutic instrument elevator base617. At this moment, since the guide wire 630 receives the force in theopposite directions between the therapeutic instrument elevator base 617and the guide wire fixture 629 alternately in the shearing manner, theguide wire 630 is releasably engaged.

[0675] Further, when using the endoscope apparatus according to thisembodiment, after the therapeutic instrument 619 such as a contrastingtube is inserted in to a pancreatic/hepatic duct (not shown) in thepapillotomy manner, the operation for replacing the therapeuticinstrument 619 is carried out as follows. The guide wire 630 is firstinserted from the mouth ring 4 b provided on the base end side of thetherapeutic instrument 619 and led to the pancreatic/hepatic duct (notshown).

[0676] Insertion of the guide wire 630 in to the pancreatic/hepatic duct(not shown) is confirmed, and the therapeutic instrument 619 is pulledout while gripping the base end side of the guide wire 630 by a hand soas to avoid movement of the guide wire 630. At this moment, afterconfirming that the end portion of the therapeutic instrument 619 hasbeen pulled out of a papilla (not shown) by an endoscopic image, thetherapeutic instrument 619 is further pulled out.

[0677] Subsequently, when the end of the therapeutic instrument 619 isaccommodated in the channel opening portion 615 on the end portion 603side of the insertion portion 602, the guide wire 630 is similarlyraised along the therapeutic instrument elevator base 617 by raising thetherapeutic instrument base 617, and the guide wire 630 is mechanicallyfixed in the vicinity of the end portion 603 of the insertion portion602 of the endoscope 601 by the guide wire fixing mechanism portion 626.

[0678] Furthermore, after confirming that the guide wire 630 is fixed,the therapeutic instrument 619 is completely pulled out from theoperation portion 606 side of the endoscope 601. Thereafter, atherapeutic instrument 619 which is subsequently used is inserted fromthe base end side of the guide wire 630 and caused to hustle against thetherapeutic instrument elevator base 617. Then, the therapeuticinstrument elevator base 617 is lowered, and only the therapeuticinstrument 619 is inserted in to the pancreatic/hepatic duct (not shown)with the guide wire 630 being used as a guide while gripping the baseend portion of the guide wire 630.

[0679] Therefore, an operator does not have to keep gripping the guidewire 630 when replacing the therapeutic instrument 619. Moreover, thetherapeutic instrument can be thereafter replaced for a necessary numberof times by the similar method.

[0680] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the therapeutic instrument 619 other thanthe guide wire 630 can be raised or moved forward/backward by operatingthe therapeutic instrument elevator base 617 as in the prior art, andonly the guide wire 630 is sandwiched between the therapeutic instrumentelevator base 617 and the guide wire fixture 629 by the operation of thetherapeutic instrument elevator base 617 and fixed in the engaged state.Therefore, in the operation for replacing the therapeutic instrument619, it is no longer necessary to grip the guide wire 630 on theoperation portion 606 side of the endoscope 601 as in the prior art byengaging only the guide wire 630 between the therapeutic instrumentelevator base 617 and the guide wire fixture 629 by the operation of thetherapeutic instrument elevator base 617. Accordingly, since there is anadvantage that the operation for replacing the therapeutic instrument619 can be facilitated, the operation time required for replacing thetherapeutic instrument 619 can be shortened.

[0681] In addition, when inserting the guide wire 630 in to thetherapeutic instrument 619, for example, 4 m of the guide wire 630 mustbe inserted in the prior art, but insertion of, e.g., approximately 2.5m of the guide wire 630 can suffice in the present invention. Thus, theentire length of the guide wire is approximately 4 m in the prior art,and more than a half of the guide wire 630 is projecting from theendoscope 601 even when it is being inserted in the endoscope 601.Therefore, the possibility that the guide wire 630 may be brought in tocontact with an unclean area such as a floor during handling is high,and caution is needed. In the present invention, however, a length ofthe part of the guide wire 630 which is projecting from the endoscope601 is short, and the possibility that the guide wire 630 may be broughtin to contact with the unclean area is low, thereby facilitatinghandling.

[0682] Further, when only the therapeutic instrument 619 is removed withthe guide wire 630 remaining at a papilla, the two operations, i.e., thetherapeutic instrument 619 is pulled out whilst the guide wire 630 ispushed in by an amount according to a removed amount of the therapeuticinstrument 619, must be carried out at the same time in the prior art.In the present invention, however, the guide wire 630 does not have tobe gripped on the operation portion 606 side, and one operation, namely,directly pulling out only the therapeutic instrument 619 can suffice.Thus, it is possible to reduce the time required for replacing thetherapeutic instrument and a number of assistants and simplify thetechnique.

[0683] Furthermore, FIGS. 86A, 86B to 89A and 89B show a 41st embodimentaccording to the present invention. In this embodiment, a guide wirefixing member 641 which is different from the guide wire fixing member621 according to the 40th embodiment and has a structure shown in FIGS.86A and 86B is attached to the end portion 603 of the insertion portion602 in the endoscope 601 according to the 40th embodiment.

[0684] That is, to the guide wire fixing member 641 according to thisembodiment are provided a substantially-funnel-like attachment portion642 and a substantially cylindrical cap portion 643 connected to the endside of the attachment portion 642.

[0685] Moreover, as shown in FIG. 87A, to the attachment portion 642 isprovided a tapered attachment portion main body 644 which has asubstantially cylindrical shape and whose outside diameter dimensionbecomes large in such a manner that its wall thickness graduallyincreases toward the base end portion side (lower side in FIG. 87A) ofthe insertion portion 602 of the endoscope 601. A plurality of, forexample, four slits 645 are formed to a cylindrical wall portion of theattachment portion main body 644 in this embodiment as shown in FIG.86B. These slits 645 are opened on the base end portion side of theattachment portion main body 644. In addition, four elasticallydeformable tongue pieces 646 are formed by parts between the respectiveslits 645.

[0686] Additionally, to the outer side of the guide wire fixing member641 is provided a fixing ring 647 which releasably fixes the attachmentportion 642 of the guide wire fixing member 641 to the end portion 603of the insertion portion 602 in the endoscope 601. The inside diameterdimension of the fixing ring 647 is set in such a manner that it islarger than a minimum outside diameter portion 646 at which the outsidediameter dimension of the tongue piece 646 of the attachment portionmain body 644 is minimum in the guide wire fixing member 641 and it issmaller than a maximum outside diameter portion 646 b at which theoutside diameter dimension of the tongue piece 646 of the attachmentportion main body 644 is maximum in the guide wire fixing member 641.

[0687] Further, as shown in FIG. 87A, in the state that the fixing ring647 is held at the engagement releasing position at which the fixingring 647 is not engaged with the tongue pieces 646 of the attachmentportion main body 644, the guide wire fixing member 641 is held so as tobe movable with respect to the insertion portion 602 of the endoscope601.

[0688] Furthermore, when the fixing ring 647 is moved in the directionof the engagement position at which the fixing ring 647 is engaged withthe tongue pieces 646 of the attachment portion main body 644, thetongue pieces 646 of the attachment portion main body 644 is inwardlypushed by the fixing ring 647 so that the inner end portion side of eachof the four tongue pieces 646 is inwardly elastically deformed.

[0689] Incidentally, in this embodiment, taking the dimensions of theend portion 603 of the insertion portion 602 in the endoscope 601 in toconsideration, the inside diameter dimension of the attachment portion642 of the guide wire fixing member 641 is set to, e.g., 14 mm, thelength of the same is set to 10 mm, and the tapered plane of the tonguepiece 646 of the attachment portion main body 646 is set to a taperangle of 5°. Moreover, the four slits 645 of the attachment portion mainbody 644 are equally arranged on the circumference of the attachmentportion 642 at intervals of substantially 90°.

[0690] In addition, the length of each slit 645 is parallel to the axialdirection of the endoscope 601 from the base end side of the attachmentportion 642 to the end side and set to approximately 9 mm. Additionally,as to a number of the slits 645 of the attachment portion main body 644,two to six is preferable when moldability or facilitation of attachmentto the endoscope 601 is taken in to consideration.

[0691] Further, the inside diameter dimension of the fixing ring 647movably attached to the attachment portion 642 is set to 16 mm, theoutside diameter dimension of the same is set to 18 mm and the width ofthe same is set to approximately 2 mm, for example.

[0692] Incidentally, the fixing ring 647 is not restricted to theabove-described dimensions, and any dimensions can be adopted as long asthe fixing ring 647 has a function for fastening the slits 645 of theattachment portion 642. Therefore, as to the shape of the fixing ring647, a belt-like member or a filate member may be used.

[0693] Furthermore, as to the materials of the attachment portion 642and the fixing ring 647, it is preferable that these members areintegrally manufactured by polycarbonate which is the same as thematerial of the cap portion 643 in terms of the cost. However, any otherhard resin such as acrylic, crude rubber, synthetic rubber, soft resinsuch as silicon or urethane, or a metal such as stainless steel may bealso used. They do not have to be transparent in particular as long asthey have the elasticity to some measure and the smooth inner surface sothat the end portion 603 of the insertion portion 602 of the endoscope601 can not be damaged.

[0694] Moreover, as in the guide wire fixing member 621 according to the40th embodiment, as shown in FIG. 86A, an opening window 648 is formedon the end side of the cap portion 643 of the guide wire fixing member641. With the end portion 603 side of the insertion portion 602 of theendoscope 601 being opened, the opening window 648 is formed at a partcorresponding to the illumination window 613, the observation window 614and the channel opening portion 615 in the side viewing reference plane612 of the end portion 603 of the endoscope 601.

[0695] In addition, a guide wire identification mechanism portion 649and a guide wire fixing mechanism portion 650 are provided to theopening window 648 of the cap portion 643. To the guide wireidentification mechanism portion 649 is provided a guide wireidentification member 651 consisting of one stainless steel wire whichis projecting with respect to the opening window 648 from one side endportion of the opening window 648 (opposite side to the observationwindow 614 in the endoscope 601) toward the inner side of the openingwindow 648. In FIG. 86A, this guide wire identification member 651 isextended from the right side of the opening window 648 to the inner sidealong the upper edge portion of the cap portion 643 and curves downward.

[0696] Additionally, guide wire fixing member insertion holes 652 arerespectively formed to the cap portion 643 on the both side portions ofthe opening window 648. These guide wire fixing member insertion holes652 are arranged at substantially central positions of the openingwindow 648 along the central line direction of the guide wire fixingmember 641.

[0697] Further, to the guide wire fixing mechanism portion 650 isprovided a guide wire fixture formed by a dilate member which is made upof, e.g., a surgical suture and as no elastic property. One end portionof the guide wire fixture 653 cuts across the opening window 648, andpasses through the guide wire fixing member insertion hole 652 on theright side of the opening window 648 in FIG. 86A. Also, the other endportion side of the guide wire fixture 653 is fixed to the guide wireidentification member 651. As a result, the guide wire fixture 653 isattached so as to be spanned between the both side portions on theopening window 648.

[0698] The effect of this embodiment will now be described. In the firstinstance, the following operation is carried out when the guide wirefixing member 641 is attached to the insertion portion 602 of theendoscope 601 of the endoscope apparatus according to this embodiment.As shown in FIG. 87A, in the engagement releasing state that the fixingring 647 has been moved to the end portion side of the guide wire fixingmember 641, the end portion 603 of the insertion portion 602 in theendoscope 601 is first inserted into the attachment portion 642 of theguide wire fixing member 641 from the slit 645 side of the guide wirefixing member 641.

[0699] Moreover, after inserting the end portion 603 of the insertionportion 602 in the endoscope 601 into the attachment portion 642, withthe opening window 648 on the cap portion 643 being matched with theposition of the channel opening portion 615 of the endoscope 601, thefixing ring 647 is again moved to the base end-portion side of the guidewire fixing member 641. At this moment, with the operation for movingthe fixing ring 647 to the base end portion side, the tongue piece 646between the respective slits 645 of the attachment portion 642 isthrusted to the inner side in the radial direction as shown in FIG. 87B.Therefore, at this moment, the inner end portion side of each of thefour tongue pieces 646 which are elastically deformed inwardly isengaged so as to be strongly welded to the outer peripheral surface ofthe insertion portion 602 of the endoscope 601 with pressure, and theguide wire fixing member 641 is immovably fixed to the insertion portion602 of the endoscope 601.

[0700] In addition, when using the endoscope apparatus according to thisembodiment, if the therapeutic instrument 619 such as a contrasting tubeis inserted into the therapeutic instrument insertion channel 616 on theoperation portion 606 side of the endoscope 601 and used, the endportion of the therapeutic instrument 619 is caused to protrude from thechannel opening portion 615 of the end portion 603 of the insertionportion 602 in the endoscope 601. At this moment, in cases where thetherapeutic instrument elevator base 617 is held at the standby position(set-down position) indicated by dotted lines in FIG. 85, the endportion of the therapeutic instrument 619 moves away from the guide wireidentification member 651 of the guide wire identification mechanismportion 649 and is held at a position enabling free movement as shown inFIG. 88A.

[0701] In this state, by manipulating a non-illustrated therapeuticinstrument elevator base operation lever of the operation portion 606 ofthe endoscope 601, the therapeutic instrument elevator base 617 of theend portion 603 of the insertion portion 602 is operated to be raised.Then, with this operation, the end portion of the therapeutic instrument619 is thrusted by the therapeutic instrument elevator base 617 in thedirection along which it is inserted into the opening window 648 of thecap portion 643.

[0702] A lower extended portion 651 a of the guide wire identificationmember 651 in the opening window 648 of the cap portion 643 is thrustedin the transverse direction by the moving operation of the therapeuticinstrument 619 at this moment. Additionally, the tensile force of theguide wire fixture 653 fixed to the guide wire identification member 651is relaxed by the moving operation of the guide wire identificationmember 651. When the tensile force of the guide wire fixture 653 isrelaxed in this manner, the therapeutic instrument 619 does notinterfere with the guide wire fixture 653 even though the end portion ofthe therapeutic instrument 619 is thrusted by the therapeutic instrumentelevator base 617 in the direction along which it is inserted into theopening window 648 of the cap portion 643, and the operation for raisingthe therapeutic instrument 619 is carried out as usual.

[0703] Further, with the end portion of the guide wire 630 being led outfrom the channel opening portion 615 of the endoscope 601, when thenon-illustrated therapeutic instrument elevator base operation lever ofthe operation portion 606 of the endoscope 601 is operated and thetherapeutic instrument elevator base 617 at the end portion 603 of theinsertion portion 602 is operated to be raised, the guide wire 630 isthrusted by the therapeutic instrument elevator base 617 in thedirection along which it is inserted into the opening window 648 asshown in FIG. 89B. At this moment, the lower extended portion 651 a ofthe guide wire identification member 651 is not thrusted by the guidewire 630 in the transverse direction, and the tensile force of the guidewire fixture 653 spanned between the both side portions over the openingwindow 648 of the guide wire fixing member 641 is not relaxed. Thus, inthis case, with the operation for raising the therapeutic instrumentelevator base 617 at the end portion 603 of the insertion portion 602 bymanipulating the non-illustrated therapeutic instrument elevator baseoperation lever, the guide wire 630 is welded with pressure to the guidewire fixture 653 between the both side portions over the opening window648 of the guide wire fixing member 641 by the thrusting force from thetherapeutic instrument elevator base 617. At this moment, since theguide wire 630 receives the force in the opposed directions alternatelyin the shearing manner between the therapeutic instrument elevator base617 and the guide wire fixture 653, it is releasably engaged.

[0704] As a result, the guide wire fixing mechanism portion 650 does notprevent the operation of the therapeutic instrument 619 when thetherapeutic instrument 619 is projecting from the channel openingportion 615 on the end portion 603 side of the insertion portion 602.Also, when only the guide wire 630 is projecting from the channelopening portion 615, the guide wire 630 is welded with pressure to andengaged with the guide wire fixture 653 between the both side portionsover the opening window 648 of the guide wire fixing member 641 by thethrusting force from the therapeutic instrument elevator base 617.

[0705] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the therapeutic instrument 619 other thanthe guide wire 630 can be operated to be raised or movedforward/backward by the operation of the therapeutic instrument elevatorbase 617 as in the prior art, and only the guide wire 630 is sandwichedand engaged between the therapeutic instrument elevator base 617 and theguide wire fixture 653 by the operation of the therapeutic instrumentelevator base 617. Therefore, in the operation for replacing thetherapeutic instrument 619, it is no longer necessary to grip the guidewire 630 on the operation portion 606 side of the endoscope 601 as inthe prior art by engaging only the guide wire 630 between thetherapeutic instrument elevator base 617 and the guide wire fixture 653by the operation of the therapeutic instrument elevator base 617.Accordingly, in this embodiment, the operation for replacing thetherapeutic instrument 619 can be facilitated as in the 40th embodiment,thereby shortening the operation time required for the operation forreplacing the therapeutic instrument 619.

[0706] Also, in addition to the advantage similar to that of the 40thembodiment, the tensile force of the guide wire fixture 653 can beadjusted by one guide wire identification member 651 in this embodimentin particular. Thus, of the two guide wire identification members 627 aand 627 b used in the 40th embodiment, the guide wire identificationmember 627 a on the observation window 614 side of the endoscope 601 canbe omitted. Therefore, there is an advantage that the visual field ofthe observation window 614 of the endoscope 601 can be assured.

[0707] Furthermore, since the principle of the fixing portion for fixingthe guide wire fixing member 641 to the end portion 603 of the insertionportion 602 in the endoscope 601 is based on the mechanicalengaging/releasing operation of the fixing ring 647 which does notutilize the resilience of rubber, it is advantageously possible to copewith a plurality of kinds of endoscopes 601 having different thicknessesat the attachment portion 642 in the guide wire fixing member 641 in onesize.

[0708] Moreover, since a rubber component of the insertion portion 602in the endoscope 601 is not scraped when the guide wire fixing member641 is attached, there is an advantage that the insertion portion 602 inthe endoscope 601 is hard to be damaged and the operation for attachingthe guide wire fixing member 641 can be further facilitated.

[0709] In addition, FIGS. 90 through 102A to 102D show a 42nd embodimentaccording to the present invention. In this embodiment, a guide wirefixing member 661 having a structure shown in FIG. 91 which is differentfrom the guide wire fixing member 621 according to the 40th embodimentis attached to the end portion 603 of the insertion portion 602 of theside viewing type endoscope 601 in the endoscope apparatus according tothe 40th embodiment.

[0710] That is, to the guide wire fixing member 661 according to thisembodiment are provided a guide wire fixing member main body 662 and anattachment member 663 for attaching the guide wire fixing member mainbody 662 to the endoscope 601 side.

[0711] The guide wire fixing member main body 662 will be firstdescribed. To the guide wire fixing member main body 662 are provided abase member 664 shown in FIGS. 94A to 94C, a guide wire fixture 665shown in FIG. 95A, a guide wire identification member 666 shown in FIGS.95B and 95C, and a top cover 667 shown in FIG. 96. Additionally, theguide wire fixture 665 and the guide wire identification member 666 aresupported so as to protrude/retreat with respect to the base member 664.

[0712] Further, a guide groove 668 for guiding the protruding/retreatingoperation of the guide wire fixture 665 and the guide wireidentification member 666 is provided on the front surface side of thebase member 664. Furthermore, as shown in FIGS. 99A and 99B, a movementrestriction portion 669 for restricting movement of the guide wirefixture 665 and the guide wire identification member 666 at a protrudingposition that the guide wire fixture 665 and the guide wireidentification member 666 are caused to protrude to the outer side ofthe base member 664 along the guide groove 668 is provided to the basemember 664 on the end portion side of the guide groove 668.

[0713] Moreover, a click groove 672 for guiding a click pin 671 of alater-described click mechanism 670 which temporarily fixes the guidewire identification member 666 is provided on the base end portion sideof the guide groove 668 of the base member 664. In addition, on the endportion side of the base member 664, stopper insertion holes 673 whichpierce from the back surface side to the front surface side arerespectively formed on the both sides of the guide groove 668 at a partin the vicinity of the movement restriction portion 669 of the guidegroove 668.

[0714] It is to be noted that an engagement groove 674 for engagementwith the attachment member 663 and a stopper fixing groove 76 for fixinga later-described stopper member 675 are provided on the back surfaceside of the base member 664 as shown in FIG. 94B.

[0715] In addition, the guide wire fixture 665 is a substantiallytabular member having a longitudinal dimension of approximately 10 mm, atransverse dimension of approximately 4 mm and a thickness ofapproximately 0.2 mm, and a material thereof is stainless steel.

[0716] Incidentally, the guide wire fixture 665 has an enough boardthickness, and its material is not restricted to stainless steel as longas it can maintain the rigidity. Any other metal material such asaluminium or hard resin such as acrylic, polycarbonate or ABS resin maybe used.

[0717] As shown in FIG. 95A, a concave impingement portion 677 whichengages with the guide wire identification member 666 is formed at theguide wire fixture 665 at the center of the base end portion. Further, aguide wire fixing portion 678 for receiving the guide wire 630 is formedat the end portion on the end side of the guide wire fixture 665.

[0718] Incidentally, it is more preferable to attach an elastic membersuch as rubber to the guide wire fixing portion 678 in order to increasethe friction between the guide wire fixing portion 678 and the guidewire 630 and prevent the guide wire 630 from being damaged.

[0719] Furthermore, shoulder portions 679 which hustle against themovement restriction portion 669 of the base member 664 of the guidewire fixing member main body 662 and slit-like stopper impingementportions 680 for receiving the stopper member 675 are respectivelyformed in the middle of the guide wire fixture 665 on the both sides.

[0720] Moreover, as shown in FIGS. 95B and 95C, the guide wireidentification member 666 is a substantially tabular member which has alongitudinal dimension of approximately 10 mm, a transverse dimension ofapproximately 4 mm and a thickness of approximately 0.4 mm, and amaterial thereof is stainless steel.

[0721] Incidentally, the guide wire identification member 666 is notrestricted to stainless steel if it has an enough board thickness andcan maintain the rigidity. Any other metal material such as aluminium orhard resin such as acrylic, polycarbonate or ABS resin may be used.

[0722] A therapeutic instrument receiving portion 681 is formed at theend portion of the guide wire identification member 666. A guide wireinsertion groove 682 which is opened on the end side and has a width ofapproximately 1 mm is formed at the central position of the therapeuticinstrument receiving portion 681. In addition, the therapeuticinstrument receiving portion 681 is configured to receive thetherapeutic instrument 619 other than the guide wire 630.

[0723] It is to be noted that fluorine coating and the like may beapplied to the therapeutic instrument receiving portion 681 in order toreduce the friction with respect to the therapeutic instrument 619 andan end of the therapeutic instrument 681 may be R-chamfered.

[0724] Additionally, a thrusting portion 683 which is bent in thesubstantially L shape as shown in FIG. 95C is formed at the base endportion of the guide wire identification member 666. Further, a largewidth portion 684 having a large lateral width is formed in the middleof the guide wire identification portion 666 at a substantially centralpart thereof. Furthermore, shoulder portions 85 which hustle against themovement restriction portion 669 of the base member 664 in the guidewire fixing member main body 662 are formed on the both sides of thelarge width portion 684 on the end portion side, and smoothly curvedstopper releasing portions 686 are formed on the both sides of the sameon the base end portion side, respectively.

[0725] Moreover, a concave portion 687 having a depth of approximately0.2 mm is formed at the large width portion 684 of the guide wireidentification member 666. A slit 688 through which a click pin 671 isinserted is formed in the concave portion 687.

[0726] In addition, as shown in FIG. 93B, the guide wire identificationmember 666 is arranged on the guide groove 668 on the front surface sideof the base member 664 of the guide wire fixing member main body 662,and the guide wire fixture 665 is arranged on the guide wireidentification member 666. Therefore, the guide wire identificationmember 666 is arranged in such a manner that it is sandwiched betweenthe base member 664 of the guide wire fixing member main body 662 andthe guide wire fixture 665.

[0727] The end side of the guide wire fixture 665 is caused to protrudefrom the base member 664 of the guide wire fixing member main body 662so as to be capable of moving forward/backward. Additionally, the endside of the guide wire fixture 665 reaches the channel opening portion615 on the end portion 603 side of the insertion portion 602 in theendoscope 601.

[0728] It is to be noted that the end side of the guide wireidentification member 666 is attached in such a manner that it is causedto protrude on the end side away from the guide wire fixture 665 so asto be capable of moving forward/backward.

[0729] Further, when the guide wire identification member 666 moves inthe direction along which it protrudes from the guide groove 668 of thebase member 664 to the outer side, the thrusting portion 683 of theguide wire identification member 666 is engaged with the impingementportion 677 of the guide wire fixture 665 in the hooked manner.

[0730] Furthermore, a stopper member 675 for causing the guide wireidentification member 666 to interlock with the guide wire fixture 665is fixed to the stopper fixing groove 76 provided on the back surfaceside of the base member 664 of the guide wire fixing member main body662. As shown in FIGS. 95D and 95E, the stopper member 675 is two thinwire rods each having a wire diameter of approximately 0.2 mm, andsuperelastic alloy manufactured by NiTi is desirable for a materialthereof. However, any other metal, e.g., stainless steel or hard resinsuch as acrylic or polycarbonate may be used as long as it is a wire rodhaving the elasticity.

[0731] Moreover, a linear portion 675 a having a substantiallyrectilinear shape is formed at the part of the thin wire rod of thestopper member 675 which is arranged on the back surface side of thebase member 664 of the guide wire fixing member main body 662. Inaddition, one end portion side of the stopper member 675 is extended tothe front surface side of the base member 664 through the stopperinsertion hole 673 opened on the end side of the base member 664 of theguide wire fixing member main body 662. In addition, a bent portion 675b which is bent in the substantially L shape is formed at the extendedportion on the front surface side of the base member 664. Additionally,the end part of the bent portion 675 b of the stopper member 675 is bentin the direction away from the base member 664 of the guide wire fixingmember main body 662 so that the end part can reach the guide wirefixture 665 across the guide wire identification member 666.

[0732] Additionally, the bent portion 675 b of the stopper member 675 isbrought into contact with the stopper releasing portion 686 of the guidewire identification member 666, and the guide wire identification member666 is configured to use the stopper releasing portion 686 to extend thespace between the bent portions 675 b in the horizontal direction.

[0733] Further, as shown in FIGS. 93A and 93B, a top cover 667 isprovided on the front surface side of the guide wire fixing member mainbody 662. A spring fixing pin 89 is provided so as to protrude on theend side of the top cover 667, and a window portion 90 from which thethrusting portion 683 of the guide wire identification member 666protrudes is formed on the base end portion side of the top cover 667.

[0734] Furthermore, a spring member 691 as a torsion bar for givingimpetus to the guide wire identification member 666 in the directionalong which the guide wire identification member 666 is pushed to theend portion side of the base member 664 is provided to the top cover667. One end portion of the spring member 691 is fixed to the springfixing pin 89, and the other end portion of the same is engaged with thethrusting portion 683 of the guide wire identification member 666.

[0735] Incidentally, it is desirable that the wire diameter of the wirestrand of the spring member 691 is, e.g., approximately 0.2 mm and thematerial thereof is superelastic alloy manufactured by NiTi.

[0736] Moreover, the click mechanism 670 for temporarily fixing theguide wire identification member 666 is provided to the guide wirefixing member main body 662 according to this embodiment. To the clickmechanism 670 are provided a click pin 671 shown in FIG. 98A and a clickgroove 672 set to the base member 664 of the guide wire fixing membermain body 662.

[0737] Although the material of the click pin 671 is stainless steel,the elasticity is not necessarily required if the material is strong tosome extent, and hard resin may be used.

[0738] Incidentally, although a circular shape may be used as thecross-sectional shape of the click pin 671, a rectangular shape and thelike by which the click pin 671 is hard to be inclined with respect tothe click groove 672 is desirable.

[0739] In addition, a U-shaped bent portion 671 a which is bent in thesubstantially U shape is formed at one end portion of the click pin 671.Additionally, an L-shaped bent portion 671 b which is bent in thesubstantially L shape is formed at the other end portion of the clickpin 671. Further, the U-shaped bent portion 671 a of the click pin 671is rotatably attached to the slit 688 of the guide wire identificationmember 666. Furthermore, the L-shaped bent portion 671 b of the clickpin 671 is movably inserted into the click groove 672 of the base member664.

[0740] It is to be noted that an edge portion 671 c which is smoothlyrounded so that it can smoothly move in the click groove 672 for guidingthe pin is formed at the pin end portion of the click pin 671 on theL-shaped bent portion 671 b side.

[0741] Moreover, the shape of the click groove 672 of the base member664 is set as shown in FIG. 98B. That is, the click groove 672 is formedinto a distorted ring shape connecting an end side convex portion 672 bwhich is arranged on the end side of the base member 664 and providedwith one linear portion 672 an extending in the substantially axialdirection, two rear end side convex portions 672 c and 672 d arranged onthe rear end side of the base member 664 side by side, and a concaveportion 672 e arranged between the two rear end side convex portions 672c and 672 d. In addition, when the guide wire fixture 665 protrudes fromthe guide groove 668 of the base member 664 of the guide wire fixingmember main body 662, the click pin 671 is arranged on the end sideconvex portion 672 b side. When the guide wire fixture 665 is embeddedin the guide groove 668 of the base member 664 of the guide wire fixingmember main body 662, the click pin 671 is arranged on the side of thetwo rear end side convex portions 672 c and 672 d.

[0742] Additionally, the inner wall of the click groove 672 is smoothalong the entire length. Taking the allowance of the click pin 671 intoconsideration, approximately 0.25 mm is desirable for the groove widthof the click groove 672, and the depth of the same is set so as to varyin a range of approximately 0.4 mm to 0.2 mm as follows. That is, thedepth of the linear portion 672 a of the click groove 672 on the endside is set to approximately 0.4 mm. A left groove 672 f and a rightgroove 672 g obtained by bifurcation are connected to the end portion ofthe linear portion 672 a. The depth of the left groove 672 f does notvary at the bifurcated portion, and it is set to approximately 0.4 mm.

[0743] Further, the depth of the right groove 672 g discontinuouslyvaries at a discontinuous point 672 h and is set to approximately 0.2mm.

[0744] Furthermore, after being bifurcated, the depth of the left groove672 f becomes shallow to 0.2 mm and reaches the rear end side convexportion 672 c on the left side.

[0745] The depth of the rear end side convex portion 672 c on the leftside becomes deep to approximately 0.4 mm at the discontinuous point 672i.

[0746] Moreover, the depth of the click groove 672 becomesdiscontinuously shallow to 0.2 mm from the rear end side convex portion672 c on the left side and reaches the concave portion 672 e. The depthof the concave portion 672 e discontinuously varies at the discontinuouspoint 672 j and is set to 0.4 mm. Then, the depth of the click groove672 becomes discontinuously shallow to 0.2 mm and reaches the rear endside convex portion 672 d on the right side. The depth of the rear endside convex portion 672 d on the right side becomes discontinuouslyvaries at the discontinuous point 672 k and is set to 0.4 mm.

[0747] In addition, the click groove 672 extends from the rear end sideconvex portion 672 d on the right side to the end side and becomes theright groove 672 g. Also, the depth of the click groove 672 becomescontinuously shallow to 0.2 mm and runs together with a bifurcation atthe dead end portion of the linear portion 672 a.

[0748] Additionally, as shown in FIGS. 92A, 97A and 97B, asubstantially-C-shaped belt-like attachment portion 693 having adiscontinuous notch portion 692 at a part of the ring is provided to theattachment member 663. The belt shape of the belt-like attachmentportion 693 is a zonal member having a width of approximately 10 mm anda thickness of approximately 0.5 mm.

[0749] Further, a mucous protection portion 694 for preventing the guidewire fixing member 661 from being caught by the mucous is provided tothe belt-like attachment portion 693 so as to protrude therefrom. Thismucous protection portion 694 is arranged on the opposite side to theobservation window 614 of the endoscope 601.

[0750] Furthermore, a positioning convex portion 95 which is fitted inthe channel opening portion 615 of the end portion 603 when attached tothe endoscope 601 is provided to the attachment member 663 so as toprotrude therefrom. Moreover, as shown in FIG. 92A,substantially-L-shaped engagement convex portions 696 which are fittedin the engagement groove 674 provided on the back surface side of thebase member 664 of the guide wire fixing member main body 662 areprovided on the both ends of the discontinuous notch portion 692 in thebelt-like attachment portion 693 so as to protrude therefrom.

[0751] Incidentally, although polycarbonate is desirable as a materialof the attachment member 663, any other resin such as rubber or metalsuch as stainless steel can suffice if it has the strength and itssurface is smoothed so as not to damage the endoscope 601.

[0752] The effect of this embodiment will now be described. Descriptionwill first be given as to the operation for attaching the guide wirefixing member 661 according to this embodiment to the end portion 603 ofthe insertion portion 602 of the endoscope 601. In the operation forattaching the guide wire fixing member 661, the convex portion 95 usedfor positioning the attachment member 663 is fitted in the channelopening portion 615 of the endoscope 601. Subsequently, thediscontinuous notch portion 692 of the belt-like attachment portion 693of the attachment member 663 being butted, the engagement convex portion696 of the attachment member 663 is fitted in the engagement groove 674of the guide wire fixing member main body 662. At this moment, as shownin FIG. 91, the guide wire fixing member 661 is slid from the end sideof the belt-like attachment portion 693, and the guide wire fixingmember 661 is fixed to the end portion 603 of the insertion portion 602in the endoscope 601.

[0753] In addition, in the case of inserting the end portion 603 of theendoscope 601 having the guide wire fixing member 661 being attachedthereto into a celoma, as shown in FIG. 92B, the mucous 697 is notcaught by the guide wire fixing member main body 662 since the mucousprotection portion 694 of the guide wire fixing member 661 thrusts awaythe mucous 697 in the celoma.

[0754] Additionally, when the therapeutic instrument 619 such as a tubeother than the guide wire 630 is inserted into the therapeuticinstrument insertion channel 616 on the operation portion 606 side ofthe endoscope 601 and is used with the end portion 603 of the endoscope601 being inserted into a celoma, the end portion of the therapeuticinstrument 619 is caused to protrude from the channel opening portion615 of the end portion 603 of the insertion portion 602 in the endoscope601. In the initial state, the therapeutic instrument elevator base 617is held at the standby position (set-down position) shown in FIGS. 101Aand 101B, and the guide wire fixing member main body 662 is held in thestate depicted in FIGS. 99A and 99B.

[0755] At this moment, impetus is given to the guide wire identificationmember 666 of the guide wire fixing member 661 in the direction alongwhich it is pushed to the end portion side of the base member 664 by thespring force of the spring member 691, and the thrusting portion 683 ofthe guide wire identification member 666 is held in the state that ithustles against the impingement portion 677 of the guide wire fixture665. Then, the click pin 671 is held in the state it is being insertedin the linear portion 672 a on the end side of the click groove 672.

[0756] Further, in case of raising the therapeutic instrument 619 fromthe initial state, the following operation is conducted. The therapeuticinstrument elevator base 617 of the end portion 603 of the insertionportion 602 is first swiveled in the elevator operation direction bymanipulating the non-illustrated therapeutic instrument elevator baseoperation lever of the operation portion 606 of the endoscope 601. Then,the end portion of the therapeutic instrument 619 is thrusted in thedirection for raising the therapeutic instrument which is orthogonal tothe axial direction of the insertion portion 602 by the therapeuticinstrument elevator base 617 with the swivel operation of thetherapeutic instrument elevator base 617.

[0757] At this moment, the end portion of the therapeutic instrument 619which is thrusted by the therapeutic instrument elevator base 617 isbrought into contact with the therapeutic instrument receiving portion681 of the guide wire identification member 666 in the middle of theswivel operation of the therapeutic instrument elevator base 617. Thus,the guide wire identification member 666 is thrusted down to the baseend side of the endoscope 601 by the subsequent swivel operation of thetherapeutic instrument elevator base 617.

[0758] Furthermore, with the operation by which the guide wireidentification member 666 is thrusted down to the base end side of theendoscope 601, the stopper member 675 is outthrusted from side to sidealong the stopper releasing portion 686 of the guide wire identificationmember 666. At this moment, when the stopper member 675 moves to thedead end position along the stopper releasing portion 686 of the guidewire identification member 666, the stopper member 675 comes off thestopper impingement portion 680 of the guide wire fixture 665 as shownin FIG. 99C. Therefore, since the stopper of the guide wire fixture 665is released in this state, the guide wire fixture 665 is also thrusteddown to the base end side of the endoscope 601 together with the guidewire identification member 666.

[0759] Then, when the end portion of the therapeutic instrument 619 isthrusted in the therapeutic instrument set-up direction orthogonal tothe axial direction of the insertion portion 602 by the therapeuticinstrument elevator base 617 as shown in FIGS. 101C and 101D, the guidewire identification member 666 is pushed to the maximum thrust positionin the guide groove 668 of the base member 664 as illustrated in FIG.99D. At this moment, the click pin 671 moves along the left groove 672 fof the click groove 672 in cooperation with the guide wireidentification member 666 and reaches the rear end side convex portion672 c on the left side.

[0760] Thereafter, by carrying out the operation for returning thetherapeutic instrument elevator base 617 in the direction toward thestandby position (set-down position) shown in FIG. 101A, the guide wireidentification member 666 is pushed back in the direction of the end ofthe insertion portion 602 by the spring force of the spring member 691as depicted in FIGS. 101E and 101F. At the same time, as shown in FIG.10A, the click pin 671 connected to the guide wire identification member666 moves to the position of the concave portion 672 e along the clickgroove 672, and the guide wire fixture 665 and the guide wireidentification member 666 are held in the thrusted state.

[0761] At this moment, since the click pin 671 has passed thediscontinuous point 672 iat the rear end side convex portion 672 on theleft side, it does not rotate in the opposite direction.

[0762] It is to be noted that the similar reverse rotation preventioneffect is provided at all the discontinuous points in the click groove672.

[0763] In this state, the guide wire fixture 665 and the guide wireidentification member 666 do not interfere with the therapeuticinstrument 619, and the guide wire fixture 665 and the guide wireidentification member 666 do not obstruct in the visual filed of theobservation window 614 of the endoscope 601.

[0764] Moreover, when the therapeutic instrument 619 is again raised,the guide wire fixture 665 and the guide wire identification member 666are again thrusted down to the maximum thrust position in the guidegroove 668 of the base member 664 as shown in FIGS. 101C and 101D. Atthis moment, as illustrated in FIG. 101B, the click pin 671 reaches therear end side convex portion 672 d on the right side along the clickgroove 672 and the locked state is released.

[0765] Thereafter, when the operation for returning the therapeuticinstrument elevator base 617 in the direction toward the standbyposition (set-down position) shown in FIG. 101A is performed, the guidewire identification member 666 is pushed back in the direction towardthe end of the insertion portion 602 by the spring force of the springmember 691. At the same time, with the movement of the guide wireidentification member 666 at this moment, the thrusting portion 683 ofthe guide wire identification member 666 is caused to hustle against theimpingement portion 677 of the guide wire fixture 665 as depicted inFIG. 100C. As a result, the guide wire fixture 665 is also thrusted tothe end side of the endoscope 601 together with the guide wireidentification member 666, thereby returning to the initial state shownin FIGS. 99A and 99B.

[0766] In addition, as illustrated in FIGS. 102A and 102B, with the endportion of the guide wire 630 being led out from the channel openingportion 615 of the endoscope 601 (initial state), when the therapeuticinstrument elevator base 617 is raised, the following operation iscarried out.

[0767] That is, when the therapeutic instrument elevator base 617 at theend portion 603 of the insertion portion 602 from the initial state iscaused to swivel, the guide wire 630 is inserted into the guide wireinsertion groove 682 provided to the therapeutic instrument receivingportion 681 at the end of the guide wire identification member 666 bythe therapeutic instrument elevator base 617 with the swivel operationof the therapeutic instrument elevator base 617 at this moment. Thus,the guide wire identification member 666 is not thrusted down by theguide wire 630 in this case.

[0768] Additionally, as shown in FIGS. 102C and 102D, the guide wire 630inserted into the guide wire insertion groove 682 of the therapeuticinstrument receiving portion 681 by swiveling of the therapeuticinstrument elevator base 617 directly hustles against the guide wirefixing portion 678 of the guide wire fixture 665.

[0769] At this moment, since the guide wire fixture 665 is restricted bythe stopper member 675 at the stopper impingement portion 680 as shownin FIG. 99A, it is not thrusted down, and the guide wire 630 is pressedbetween the therapeutic instrument elevator base 617 and the guide wirefixture 665 and fixed in the engaged state.

[0770] Incidentally, when releasing engagement of the guide wire 630, itis good enough to effect the operation for returning the therapeuticinstrument elevator base 617 in the direction toward the standbyposition (set-down position) shown in FIGS. 102A and 102B.

[0771] The following advantage can be demonstrated in this embodiment.That is, in this embodiment, the therapeutic instrument 619 other thanthe guide wire 630 can be operated to be raised or movedforward/backward by manipulation of the therapeutic instrument elevatorbase 617 as in the prior art, and only the guide wire 630 is sandwichedbetween the therapeutic instrument elevator base 617 and the guide wirefixture 665 and fixed in the engaged manner by manipulation of thetherapeutic instrument elevator base 617. Therefore, in case of theoperation for replacing the therapeutic instrument 619, the necessity togrip the guide wire 630 on the operation portion 606 side of theendoscope 601 as in the prior art can be eliminated by engaging only theguide wire 630 between the therapeutic instrument elevator base 617 andthe guide wire fixture 665 by manipulating the therapeutic instrumentelevator base 617. Accordingly, since there is as advantage that theoperation for replacing the therapeutic instrument 619 is facilitatedalso in this embodiment as in the 40th embodiment, the operation timerequired for replacing the therapeutic instrument 619 can be reduced.

[0772] Also, in addition to the advantage similar to that of the 40thembodiment, this embodiment has an advantage that actuation of the guidewire identification member 666 is secure and the visual field of theobservation window 614 of the endoscope 601 can be further widelyassured.

[0773] Further, FIGS. 103A to 103J and FIGS. 107A to 107D show a 43rdembodiment according to the present invention. In this embodiment, thestructure of the guide wire fixing member main body 662 in the guidewire fixing member 661 according to the 42nd embodiment is changed asfollows.

[0774] Incidentally, parts other than the above have the structure equalto that of the 42nd embodiment, and like reference numerals denote partssimilar to these of the 42nd embodiment, thereby omitting theirexplanation.

[0775] That is, to the guide wire fixing member main body 662 accordingto this embodiment are provided a guide wire fixture 701 show in FIG.103D and a guide wire identification member 702 depicted in FIGS. 103Eand 103F which have the structures different from those of the guidewire fixture 665 and the guide wire identification member 666 accordingto the 42nd embodiment.

[0776] A substantially-V-shaped guide wire engagement groove 703 whosewidth is smaller than the outside diameter dimension of the guide wire630 is formed at the end portion of the guide wire fixture 701 accordingto this embodiment. Furthermore, a stopper impingement portion 704 forreceiving a later-described stopper member is provided at a central partof the guide wire fixture 701 on the base end portion side.

[0777] Moreover, a large width portion 705 having a large transversewidth is formed in the middle of the guide wire fixture 701. Inaddition, shoulder portions 106 which hustle against the movementrestriction portion 669 of the base member 664 are formed on the bothsides of the large width portion 705 on the end portion side, and guidewire identification member impingement portions 707 are formed on theboth sides of the large width portion 705 on the base end portion side.

[0778] Additionally, the guide wire identification member 702 accordingto this embodiment is configured as shown in FIGS. 103E and 103F. Atherapeutic instrument receiving portion 708 is formed at the endportion of the guide wire identification member 702. A guide wireinsertion groove 709 which is opened on the end side is formed at acentral part of the therapeutic instrument receiving portion 708.Further, the therapeutic instrument receiving portion 708 is configuredto receive the therapeutic instrument 619 other than the guide wire 630.

[0779] Further, a large width portion 710 having a large transversewidth is formed on the base end portion side of the guide wireidentification member 702. Furthermore, shoulder portions 711 whichhustle against the movement restriction portion 669 of the base member664 in the guide wire fixing member main body 662 are formed on the bothsides of the large width portion 710 on the end portion side.

[0780] Moreover, a bifurcated edge portion 712 which is bifurcated asshown in FIG. 103E is formed at the base end portion side of the largewidth portion 710. As shown in FIG. 103F, to the bifurcated edge portion712 are formed stopper releasing portions 713 each of which has a boardthickness smoothly changing into a wall thickness from the base endportion side to the end portion side. In addition, a thrusting portion744 for the guide wire fixture 701 is formed at a step portion at theend of each stopper releasing portion 713. Additionally, when the guidewire identification member 702 protrudes, a guide wire identificationmember impingement portion 707 of the guide wire fixture 701 isconfigured to receive the thrusting portion 714 for the guide wireidentification member 702.

[0781] It is to be noted that at the large width portion 710 of theguide wire identification member 702 are formed a concave portion 715and a slit 716 which are similar to the concave portion 687 and the slit688 of the guide wire identification member 666 according to the 42ndembodiment.

[0782] Further, FIGS. 103A to 103C show the base member 664 of the guidewire fixing member main body 662 according to this embodiment. To theend portion of the base member 664 on the front surface side is attacheda substantially-T-shaped stopper member 717 which has a top coverfunction for covering the guide wire fixture 701 and causes the guidewire identification member 702 and the guide wire fixture 701 tointerlock with each other as shown in FIG. 103G.

[0783] This stopper member 717 is a platy member having a boardthickness of approximately 0.2 mm, and superelastic alloy manufacturedby NiTi is desirable as a material thereof. However, a member having theelasticity such as stainless steel can suffice.

[0784] A fixing portion 717 a which is fixed on the end portion on thefront surface side of the base member 664 of the guide wire fixingmember main body 662 is provided on the end side of the stopper member717. Furthermore, as shown in FIG. 103H, a bent portion 717 b which isbent at substantially 90 degrees is provided to the base end portion ofthe stopper member 717. The bent portion 717 b is in contact with thestopper impingement portion 704 of the guide wire fixture 701.

[0785] Moreover, a click mechanism 718 having a structure different fromthat of the click mechanism 670 according to the 42nd embodiment isprovided on the base end portion side of the guide groove 668 of thebase member 664. To the click mechanism 718 are provided a click pin 719shown in FIG. 103I which has the same structure as the click pin 671according to the 42nd embodiment and a click groove 720 shown in FIG.103J which is arranged on the base end portion side of the guide groove668 in the base member 664 of the guide wire fixing member main body662.

[0786] In addition, a U-shaped bent portion 719 a which is bent in thesubstantially U shape is formed at one end portion of the click pin 719.Additionally, an L-shaped bent portion 719 b which is bent in the Lshape at substantially right angles is formed at the other end portionof the click pin 719. Further, the U-shaped bent portion 719 a of theclick pin 719 is rotatably attached to the slit 716 of the guide wireidentification member 702. Furthermore, the L-shaped bent portion 719 bof the click pin 719 is movably inserted into the click groove 720 ofthe base member 664.

[0787] An edge portion 719 c which is smoothly rounded so as to smoothlymove in the click groove 720 for guiding the pin is formed at the pinend portion of the click pin 719 on the L-shaped bent portion 719 bside.

[0788] Moreover, the shape of the click groove 720 of the base member664 is set as shown in FIG. 103J. That is, the click groove 720 isformed into a substantially triangular distorted ring shape including agroove end portion 720 a arranged on the end side of the base member664, a groove rear end portion 720 b arranged on the rear end side ofthe base member 664, a linear groove portion 720 c connecting the grooveend portion 720 c and the groove rear end portion 720 b to each other, ahole portion 720 d arranged on the side of the linear groove portion 720c, a linear groove portion 720 e connecting the hole portion 720 d andthe groove end portion 720 a to each other, and a linear groove portion720 f connecting the hole portion 720 d and the groove rear end portion720 b to each other. In addition, when the guide wire fixture 701protrudes from the guide groove 668 of the base member 664 of the guidewire fixing member main body 662, the click pin 719 is arranged on thegroove end portion 720 a side. Also, when the guide wire fixture 701 isembedded in the guide groove 668 of the base member 664 of the guidewire fixing member main body 662, the click pin 719 is arranged on thegroove rear end portion 720 b side.

[0789] Description will now be given as to the detailed structure of theshape of the click groove 720 of the base member 664. That is, the depthof the linear groove portion 720 e connecting the groove end portion 720a and the hole portion 720 d of the click groove 720 is set toapproximately 0.4 mm. The depth of the hole portion 720 d is set toapproximately 0.6 mm. Further, the distance between the hole portion 720d and the groove rear end portion 720 b is set to approximately 0.5 mm.Furthermore, the depth becomes continuously shallow between the holeportion 720 d and the groove rear end portion 720 b and is set to 0.2mm. The click groove 720 discontinuously has the depth of 0.4 mm at thediscontinuous point 720 g of the groove rear end portion 720 b. Then,this groove extends from the groove rear end portion 720 b to the endside along the liner groove portion 720 c and its depth becomescontinuously shallow to 0.2 mm. Also, it runs together with the grooveend portion 720 a on the end side through the discontinuous point 720 h.

[0790] The effect of the guide wire fixing member main body 662according to this embodiment will now be described. FIGS. 106A to 106Fshow the operation state when the therapeutic instrument 619 other thanthe guide wire 630 is raised by using the guide wire fixing member 661,and FIGS. 107A to 107D show the operation state when the guide wire 630is raised by using the guide wire fixing member 661.

[0791] Description will be first given as to the case where thetherapeutic instrument 619 other than the guide wire 630 is raised. Whenthe therapeutic instrument 619 such as a contrasting tube other than theguide wire 630 is inserted into the therapeutic instrument insertionchannel 616 on the operation portion 606 side of the endoscope 601 andused with the end portion 603 of the endoscope 601 being inserted into aceloma, the end portion of the therapeutic instrument 619 is caused toprotrude from the channel opening portion 615 at the end portion 603 ofthe insertion portion 602 in the endoscope 601. In the initial state,the therapeutic instrument elevator base 617 is held at the standbyposition (set-down position) shown in FIGS. 106A and 106B, and the guidewire fixing member 661 is held in the state depicted in FIGS. 104A and104B.

[0792] At this moment, impetus is given to the guide wire identificationmember 702 of the guide wire fixing member 661 in the direction forthrusting to the end portion side of the base member 664 by the springforce of the spring member 691, and the thrusting portion 714 of theguide wire identification member 702 is held in such a manner that it iscaused to hustle against the guide wire identification memberimpingement portion 707 of the guide wire fixture 701. Moreover, theclick pin 719 is held being inserted in the groove end portion 720 a onthe end side of the click groove 720.

[0793] In addition, in case of raising the therapeutic instrument 619from the initial state, the following operation is conducted. Thetherapeutic instrument elevator base 617 at the end portion 603 of theinsertion portion 602 is first swiveled in the elevator operationdirection by manipulating the non-illustrated therapeutic instrumentelevator operation lever of the operation portion 606 in the endoscope601. Then, with the swivel operation of the therapeutic instrumentelevator base 617, the end portion of the therapeutic instrument 619 isthrusted in the direction for raising the therapeutic instrument whichis orthogonal to the axial direction of the insertion portion 602 by thetherapeutic instrument elevator base 617.

[0794] At this moment, the end portion of the therapeutic instrument 619thrusted by the therapeutic instrument elevator base 617 is brought intocontact with the therapeutic instrument receiving portion 708 of theguide wire identification member 702 in the middle of the swiveloperation of the therapeutic instrument elevator base 617. Thus, theguide wire identification member 702 is thrusted down to the base endside of the endoscope 601 by the subsequent swivel operation of thetherapeutic instrument elevator base 617.

[0795] Additionally, with the operation for thrusting down the guidewire identification member 702 to the base end side of the endoscope601, the bent portion 717 b of the stopper member 717 is pushed up in adirection along which it moves away from the stopper impingement portion704 of the guide wire fixture 701 by the stopper releasing portion 713of the guide wire identification member 702. At this moment, when thestopper member 717 moves to the dead end position along the stopperreleasing portion 713 of the guide wire identification member 702, thestopper member 717 comes off the stopper impingement portion 704 of theguide wire fixture 701 as shown in FIG. 104D. Therefore, since thestopper of the guide wire fixture 701 is released in this state, theguide wire fixture 701 is also thrusted down to the base end side of theendoscope 601 together with the guide wire identification member 702. Atthis moment, the click pin 719 moves along the linear groove portion 720e of the click groove 720 on the left side in FIG. 103J in cooperationwith the guide wire identification member 702.

[0796] Then, when the end portion of the therapeutic instrument 619 isthrusted in the direction for raising the therapeutic instrument whichis orthogonal to the axial direction of the insertion portion 602 by thetherapeutic instrument elevator base 617 as shown in FIGS. 106C and106D, the guide wire identification member 702 is pushed into the guidegroove 668 of the base member 664 to the thrust position shown in FIGS.104E and 104F. At this moment, the click pin 719 reaches the holeportion 720 d. The click pin 719 is caught by the hole portion 720 d andfixed in the engaged state. Therefore, the guide wire fixture 701 andthe guide wire identification member 702 are held in the thrusted stateas shown in FIGS. 104E and 104F.

[0797] When the therapeutic instrument elevator base 617 is lowered alittle from this state, the guide wire fixture 701 and the guide wireidentification member 702 do not interfere with the therapeuticinstrument 619, and the guide wire fixture 701 and the guide wireidentification member 702 do not obstruct in the visual field of theobservation window 614 of the endoscope 601.

[0798] Further, when the therapeutic instrument 619 is again set-up, theguide wire fixture 701 and the guide wire identification member 702 arethrusted down to the maximum thrust position in the guide groove 668 asshown in FIGS. 105A and 105B. At this moment, the click pin 719 movesout of the hole portion 720 d of the click groove 720 and reaches thegroove rear end portion 720 b along the linear groove portion 720 f,thereby releasing the locked state.

[0799] Thereafter, when the operation for returning the therapeuticinstrument elevator base 617 to the direction of the standby position(set-down position) shown in FIGS. 106A and 106B is carried out, theguide wire identification member 702 is pushed back to the direction ofthe end of the insertion portion 602 by the spring force of the springmember 691. At the same time, with the moving operation of the guidewire identification member 702 at this moment, the thrusting portion 714of the guide wire identification member 702 is caused to hustle againstthe impingement portion 707 of the guide wire fixture 701 as shown inFIGS. 105C and 105D. As a result, the guide wire fixture 701 is alsopushed to the end side of the endoscope 601 together with the guide wireidentification member 702 and returns to the initial state shown inFIGS. 104A and 104B.

[0800] Furthermore, as shown in FIGS. 107A and 107B, when thetherapeutic instrument elevator base 617 is raised with the end portionof the guide wire 630 being led out from the channel opening portion 615of the endoscope 601 (initial state), the following operation isperformed.

[0801] That is, when the therapeutic instrument elevator base 617 of theend portion 603 of the insertion portion 602 is operated to swivel fromthe initial state mentioned above, the guide wire 630 is inserted in theguide wire insertion groove 709 of the therapeutic instrument receivingportion 708 provided at the end of the guide wire identification member702 by the therapeutic instrument elevator base 617 with the swivelingoperation of the therapeutic instrument elevator base 617 at thismoment. Therefore, in this case, the guide wire identification member702 is not thrusted down by the guide wire 630.

[0802] Moreover, the guide wire 630 existing in the guide wire insertiongroove 709 of the therapeutic instrument receiving portion 708 reachesthe position of the end portion 701 a of the guide wire fixture 701 byswiveling of the therapeutic instrument elevator base 617. At thismoment, since the guide wire identification member 702 is not thrusteddown, the guide wire fixture 701 is restricted with the stopper member717 being engaged with the stopper impingement portion 704 and hence itis not thrusted down.

[0803] In addition, when the therapeutic instrument elevator base 617 isoperated to be raised, the guide wire 630 is pressed against the guidewire engagement groove 703 of the end portion 701 a of the guide wirefixture 701 by the therapeutic instrument elevator base 617 and fixed insuch a manner that it is held by and engaged with the guide wireengagement groove 703 as shown in FIGS. 107C and 107D.

[0804] Incidentally, when releasing engagement of the guide wire 630,the therapeutic instrument 619 is inserted with the guide wire 630 beingused as a guide and caused to protrude from the channel opening portion615 at the end portion 603 of the insertion portion 602 in the endoscope601. As a result, the therapeutic instrument 619 pushes out the guidewire 630 in the direction along which the guide wire 630 comes off theguide wire engagement groove 703, thereby releasing engagement.

[0805] The following advantage can be obtained in this embodiment. Thatis, in this embodiment, the therapeutic instrument 619 other than theguide wire 630 can be operated to be raised or moved forward/backward bymanipulation of the therapeutic instrument elevator base 617 as in theprior art, and only the guide wire 630 is pressed against the guide wireengagement groove 703 at the end portion 701 a of the guide wire fixture701 by the therapeutic instrument elevator base 617 and fixed so as tobe held by and engaged with the guide wire engagement groove 703.Therefore, in case of the operation for replacing the therapeuticinstrument 619, the necessity of gripping the guide wire 630 on theoperation portion 606 side of the endoscope 601 as in the prior art canbe eliminated by engaging only the guide wire 630 with the guide wireengagement groove 703 at the end portion 701 a of the guide wire fixture701 by manipulating the therapeutic instrument elevator base 617.Accordingly, since the operation for replacing the therapeuticinstrument 619 can be facilitated also in this embodiment as in the 40thembodiment, the operation time required for replacing the therapeuticinstrument 619 can be reduced.

[0806] Also, in addition to the advantage similar to that of the 40thembodiment, this embodiment has an advantage that a number ofconstituent components of the guide wire fixing member main body 662 canbe reduced and the operation for assembling the guide wire fixing membermain body 662 can be facilitated.

[0807] In addition, FIGS. 108A to 108E show a 44th embodiment accordingto the present invention. In this embodiment, a guide wire fixing member731 having a structure different from that of the guide wire fixingmember 621 according to the 40th embodiment is provided to the endportion 603 of the insertion portion 602 of the side viewing typeendoscope 601 in the endoscope apparatus according to the 40thembodiment.

[0808] That is, in this embodiment, an external channel 732 is providedalong the side surface of the insertion portion 602 in the endoscope 601over the substantially entire length of the insertion portion 602. The2nd portion of the external channel 732 is arranged at a part in thevicinity of the channel opening portion 615 provided at the end portion603 of the insertion portion 602. Additionally, the base end portion ofthe external channel 732 is arranged at a part in the vicinity of theoperation portion 606 (see FIGS. 114A and 114B) in the endoscope 601.

[0809] Further, the guide wire fixing member 731 according to thisembodiment is inserted into the external channel 732 so as to be capableof moving forward/backward therein without restraint. FIG. 108A shows anexample in which a gripping therapeutic instrument 733 is used as theguide wire fixing member 731. Furthermore, FIG. 108B shows an example inwhich a snare 734 is used as the guide wire fixing member 731, and FIG.108C shows an example in which a guide wire thruster 735 is used as aguide wire fixing member 731.

[0810] Moreover, although a porous PTFE is desirable as a material ofthe external channel 732, the material is not restricted to porous PTFEas long as it has a nearly equal hardness and buckling resistantproperty. If the material of the external channel 732 is hard, theexternal channel 732 may buckle or the stiffness of the insertionportion 602 may increase depending on the insertion shape of theendoscope 601, thereby reducing the insertion ability.

[0811] On the contrary, if the material of the external channel 732 issoft, the amount of force needed for advance or retreat of the guidewire fixing member 731 is increased. Therefore, the hardness of theexternal channel 732 can be set to the appropriate state by forming theexternal channel 732 by using porous PTFE.

[0812] As to the dimensions of the inside and outside diameters of theexternal channel 732, the small outside diameter is preferable whentaking into consideration the insertion ability into a celoma. On theother hand, however, when the outside diameter dimension of the guidewire fixing member 731 to be inserted into the external channel 732 istaken into account, a diameter of at least approximately 3 mm isnecessary, and it is desirable to set the inside diameter toapproximately 3 mm and the outside diameter to approximately 4 mm, forexample.

[0813] Incidentally, an arm portion 737 which is a gripping portion andcan be opened/closed is provided on the gripping therapeutic instrument733 of the guide wire fixing member 731 at the end portion of theoperation wire 736. In addition, the arm portion 737 is configured tohold the guide wire 630 therein. Additionally, as shown in FIG. 108D,zigzag grooves 737 a or irregular grooves 737 b to prevent slippingwhich are substantially orthogonal to the axial direction of the guidewire 630 are formed on the contact plane in the arm portion 737 withrespect to the guide wire 630. The grooves on the contact plane in thearm portion 737 with respect to the guide wire 630 may be formed in thestaggered manner so that the opposed grooves can be fitted to eachother.

[0814] Further, as shown in FIG. 108E, the contact plane with which theguide wire 630 is brought into contact may be covered with resin such asrubber 737 c.

[0815] It is to be noted that a loop-like snare wire 738 is provided forthe snare 734 shown in FIG. 108B at the end portion of the operationwire 736 b. The snare wire 738 is configured to grip the guide wire 630therein. Furthermore, a tabular thrusting plate 739 is provided to theguide wire thruster 735 shown in FIG. 108C at the end portion of theoperation wire 736 b. Moreover, it is configured that the guide wire 630is gripped between the thrusting plate 739 and the therapeuticinstrument elevator base 617.

[0816] The effect of this embodiment will now be described. At first, incase of raising the therapeutic instrument 619 other than the guide wire630, the gripping therapeutic instrument 733 as the guide wire fixingmember 731 is accommodated in the external channel 732 so as not toaffect the operation of the therapeutic instrument 619.

[0817] In addition, when raising the guide wire 630, the grippingtherapeutic instrument 733 is caused to protrude from the externalchannel 732, the operation portion (not shown) of the grippingtherapeutic instrument 733 provided on the operation portion 606 side ofthe endoscope 601 is operated while confirming using an endoscopicimage, and the guide wire 630 is gripped.

[0818] Additionally, the non-slip grooves which are substantiallyorthogonal to the guide wire 630 are formed on the contact plane in thearm portion 737 of the gripping therapeutic instrument 733 with respectto the guide wire 630. When the opposed grooves are staggered so thatthey can be fitted to each other, the guide wire 630 is engaged so as toreceive the force in the shearing manner along the grooves of the armportion 737.

[0819] Further, when the guide wire fixing member 731 is the snare 734,the snare wire 738 at the end of the snare 734 is caused to protrudefrom the external channel 732 and opened, and the guide wire 630 isinserted into the snare wire 738. In this state, the operation portion(not shown) of the snare provided on the operation portion 606 side ofthe endoscope 601 is manipulated, and the loop of the snare wire 736 isdecreased, thereby engaging the guide wire 630.

[0820] Furthermore, when the guide wire fixing member 731 is the guidewire thruster 735, the guide wire 630 is raised, and the guide wirethruster 735 is pushed in from the operation portion 606 side of theendoscope 601, and the guide wire 630 is sandwiched between thetherapeutic instrument elevator base 617 and the guide wire thruster735, thereby engaging the guide wire 630.

[0821] The following advantage can be demonstrated in this embodiment.That is, in addition to the advantage similar to that of the 40thembodiment, the guide wire fixing member 731 according to thisembodiment can be used to fix and release the guide wire 630 by the willof an operator, and the existing gripping therapeutic instruments can beused, thereby readily making preparations.

[0822] Moreover, when there are grooves on the plane with which theguide wire 630 is brought into contact, the force for fixing the guidewire 630 can be increased. In addition, when the plane with which theguide wire 630 is brought into contact is covered with resin such asrubber, the force for fixing the guide wire 630 can be increased and theguide wire 630 can be prevented from being damaged.

[0823] Additionally, in cases where the guide wire fixing member 731 isthe snare 734, by inserting the guide wire 630 into the loop of thesnare wire 738 in the first operation, the operation for assuring theguide wire 630 can be facilitated when fixing the guide wire 630 in thesecond and subsequent operations.

[0824] Further, if the guide wire fixing member 731 is the guide wirethruster 735, since only the operation wire 736 c for operating theguide wire thruster 735 can be inserted into the external channel 732,the inside and outside diameters of the external channel 732 can bereduced, and the insertion ability with respect to a celoma can be henceimproved.

[0825] Furthermore, FIG. 109 shows a 45th embodiment according to thepresent invention. In this embodiment, the structure of the guide wirefixing member 621 according to the 40th embodiment is changed asfollows.

[0826] Incidentally, any other parts have the same structure as the 40thembodiment, and like reference numerals denote parts similar to those inthe 40th embodiment, thereby omitting their explanation.

[0827] That is, in the guide wire fixing member 621 according to thisembodiment, one end portion of the guide wire fixture 629 is fixed tothe guide wire fixture insertion hole 628 arranged on one side of thetherapeutic instrument insertion opening window 624 of the cap portion623. The guide wire fixture 629 cuts across the therapeutic instrumentinsertion opening window 624 and passes through the other guide wirefixture insertion hole 628 of the therapeutic instrument insertionopening window 624. Then, the guide wire fixture 629 is extended to theoperation portion 606 side of the endoscope 601 through the therapeuticinstrument insertion channel 616 provided inside the insertion portion602 of the endoscope 601. Moreover, the extended end portion of theguide wire fixture 629 is configured to be connected to the operationportion (not shown) of the guide wire fixture 629 provided on theoperation portion 606 side of the endoscope 601.

[0828] The effect of this embodiment will now be described. In thisembodiment, when the therapeutic instrument 619 other than the guidewire 630 is raised, the guide wire fixture 629 is loosened on theoperation portion 606 side of the endoscope 601 so as not to preventset-up of the therapeutic instrument 619.

[0829] In addition, when the guide wire 630 is raised, the guide wirefixture 629 is pulled from the operation portion 606 side of theendoscope 601, and the tensile force is generated to the guide wirefixture 629 cutting across the therapeutic instrument insertion openingwindow 624 of the cap portion 623. In this state, the guide wire 630 israised by the therapeutic instrument elevator base 617, and the guidewire 630 is sandwiched and engaged between the therapeutic instrumentelevator base 617 and the guide wire fixture 629 cutting across thetherapeutic instrument insertion opening window 624.

[0830] The following advantage can be demonstrated in this embodiment.That is, in addition to the advantage similar to that of the 40thembodiment, in this embodiment, the guide wire 630 can be fixed andreleased by the will of an operator and there is no external channel 732according to the 44th embodiment, thereby improving the insertionability to a celoma.

[0831] Additionally, FIGS. 110A to 110C show a 46th embodiment accordingto the present invention. In this embodiment, the structure of the guidewire fixing member 731 according to the 44th embodiment is changed asfollows.

[0832] That is, in this embodiment, the gripping therapeutic instrument733 is attached to the end portion 603 of the insertion portion 602 inthe endoscope 601. Further, a bending portion 741 is connected to therear end portion of the end portion 603 of the insertion portion 602. Awire fixing ring 742 is fixed to the bending portion 741 on the base endside. Furthermore, the base end portion of the operation wire 736 a ofthe gripping therapeutic instrument 733 is fixed to the wire fixing ring742.

[0833] The effect of this embodiment will now be described. In thisembodiment, as shown in FIG. 110B, when the guide wire 630 is raised,the bending portion 741 of the endoscope 601 is once curved, and theoperation wire 736 a is loosened. In this state, an endoscopic image isused to confirm that the guide wire 630 has been raised so that it canbe held by the arm portion 737 of the gripping therapeutic instrument733.

[0834] Then, curve of the bending portion 741 in the endoscope 601 isreleased. As a result, as shown in FIG. 110C, the operation wire 736 abecomes tensed, the arm portion 737 of the gripping therapeuticinstrument 733 is closed, and the guide wire 630 is engaged with the armportion 737 so as to be held therein.

[0835] The following advantage can be demonstrated in this embodiment.That is, in addition to the advantage of the 44th embodiment, in thisembodiment, the external channel 732 does not have to be attached and itdoes not take troubles to insert the operation wire into the therapeuticinstrument insertion channel 616 as in the 45th embodiment.

[0836] It is to be noted that the present invention is not restricted tothe foregoing embodiments. For example, a shown in FIGS. 111A and 111B,the guide wire fixing member 753 consisting of the guide wire fixingmechanism portion 751 and the attachment member 752 may be attached tothe end portion 603 of the insertion portion 602 in the endoscope 601having the therapeutic instrument elevator base 617. Moreover, as shownin FIGS. 111C and 111D, the guide wire fixing member 754 consisting ofonly the guide wire fixing mechanism portion 751 included in the endportion 603 of the insertion portion 602 in the endoscope 601 may beprovided. The guide wire fixture 755 is included in the guide wirefixing mechanism portion 751.

[0837] Meanwhile, FIGS. 111A and 111C show the state in which thetherapeutic instrument elevator base 617 is raised with the end portionof the therapeutic instrument 619 other than the guide wire 630 beingled out from the channel opening portion 615 of the endoscope 601, andFIGS. 111B and 111D show the state in which the therapeutic instrumentelevator base 617 is raised with the end portion of the guide wire 630being led out from the channel opening portion 615 of the endoscope 601,respectively.

[0838] In addition, the endoscope 601 used in the present invention maybe an existing endoscope 761 as shown in FIGS. 112A and 112B.Additionally, as illustrated in FIGS. 112C and 112D, it may be anendoscope 763 having a guide wire fixing member installation space 762in which the guide wire fixing mechanism portion 751 is previouslyincorporated to the end portion 603 of the insertion portion 602 of theendoscope 601.

[0839] Further, as depicted in FIGS. 112E and 112F, it may be anendoscope 765 having the attachment member 764 of the guide wire fixingmechanism portion 751. Furthermore, as shown in FIGS. 112G and 112H, itmay be an endoscope 767 in which the guide wire fixing member 766 havingthe guide wire fixing mechanism portion 751 being undetachably included.

[0840] Moreover, although the guide wire must have the length which istwofold of that of the therapeutic instrument when inserting/removingthe therapeutic instrument running on the guide wire in the prior art,the length of the guide wire 630 a in this embodiment may be not morethan twofold of that of the therapeutic instrument since the guide wire630 a can be fixed in the vicinity of the end of the endoscope. Inaddition, in the endoscope 601 used in the present invention, it is goodenough that the guide wire 630 a has a length that it protrudes by anamount not more than 40 cm from the channel opening portion 615 of theendoscope 601 toward the inside of the body and protrudes approximately10 cm from the mouth ring 4 a (see FIGS. 114A and 114B) provided on thebase end side of the therapeutic instrument 619.

[0841] That is, although the existing guide wire 5 (see FIGS. 114A and114B) having a length of approximately 400 cm can be used, the guidewire 630A having an entire length of not more than 250 cm can be used inthis embodiment as shown in FIG. 113A.

[0842] Additionally, although 1 mm or a shorter length is desirable asthe outside diameter dimension of the guide wire 630A, it does not haveto be restricted in particular.

[0843] Further, as shown in FIG. 113B, it is possible to use theextendable guide wire 630 b provided with connection portions 630 b and630 b by which the extension guide wire 630 a can be connected to thebase end portion side of the guide wire 630B according to needs.Alternatively, as illustrated in FIG. 113C, the guide wire 630C having acircular portion 630 d which is curved in the circular form at the endthereof can suffice.

[0844] Furthermore, as the therapeutic instrument 619, existingtherapeutic instruments can be used as they are. A therapeuticinstrument having a coated guide wire lumen in order to reduce thefrictional force with respect to the guide wire 630 or anothertherapeutic instrument having the inner surface being smoothed is morepreferable in this embodiment.

[0845] Moreover, when the therapeutic instrument 619 is projecting fromthe channel opening portion 615 on the end portion 603 side of theinsertion portion 602, the guide wire fixing mechanism portion 751 doesnot obstruct the operation of the therapeutic instrument 619. When onlythe guide wire 630 is projecting, the guide wire fixing mechanismportion 751 can fix the guide wire 630.

[0846] For example, as illustrated in connection with the 44th and 45thembodiments, the guide wire fixing mechanism portion may be operated inthe vicinity of the operation portion 606 of the endoscope 601 by usingoperation wires 736 b and 736 c and others arranged in the therapeuticinstrument insertion channel 616 or the external channel 732 providedbeside the endoscope insertion portion 602 so as to be capable of movingforward/backward, or it may be automatically operated by the guide wireidentification mechanism portion as illustrated in the 40th and 43rdembodiment.

[0847] In addition, the present invention is not restricted to theforegoing embodiments, and various modifications can be of coursecarried out without departing from the scope of the present invention.

[0848] According to the present invention, when the end portion of theguide wire inserted into the therapeutic instrument insertion channel isled out from the end opening portion of the therapeutic instrumentinsertion channel, the guide wire is releasably engaged by the guidewire fixing means in the vicinity of the end portion of the insertionportion. Therefore, at the time of replacing the therapeutic instrument,the guide wire does not have to be gripped on the endoscope operationportion side. Accordingly, the therapeutic instrument can be readilyreplaced in a shorter time and one operator can perform replacementwithout impairing the conventional operation method of the therapeuticinstrument or the sense of operation.

[0849] The present invention is effective in the technical field ofusing a combination of therapeutic instruments and the endoscope suchthat the operation for replacing the therapeutic instrument is carriedout by using the guide wire, the field for manufacturing and using theendoscope, and the technical field of a treatment method for curing byusing this endoscope system.

What is claimed is:
 1. An endoscope in which a therapeutic instrumentinsertion channel is provided in an insertion portion inserted into aceloma and an end opening portion of said therapeutic instrumentinsertion channel is provided in the vicinity of an end of saidinsertion portion, wherein a guide wire for guiding an insertionoperation of a therapeutic instrument is inserted into said therapeuticinstrument insertion channel; and said insertion portion has a guidewire fixing means for releasably engaging said guide wire when saidtherapeutic instrument running on said guide wire is inserted/removedwith an end portion of said guide wire being led out from said endopening portion of said therapeutic instrument insertion channel.
 2. Theendoscope according to claim 1, wherein said guide wire fixing means isprovided in the vicinity of said distal end portion of said insertionportion.
 3. The endoscope according to claim 1, wherein said guide wirefixing means is constituted by a therapeutic instrument elevator baseprovided in the vicinity of said end opening portion of said therapeuticinstrument insertion channel and a constituent member provided at aopposed position when said therapeutic instrument elevator base israised.
 4. The endoscope according to claim 3, wherein a slit capable ofengaging only said guide wire by raising said guide wire by manipulatingsaid therapeutic instrument elevator base is provided at a top portionof a guide plane of said therapeutic instrument elevator base.
 5. Theendoscope according to claim 4, wherein said slit is provided on a topface of an opening portion of said therapeutic instrument insertionchannel of a distal end hard portion.
 6. The endoscope according toclaim 4, further comprising a wire contact plane provided on a topportion of said opening portion of said therapeutic instrument insertionchannel, wherein when said elevator base is swiveled and raised and saidguide wire is held/fixed between said slit and said wire contact plane,a contact portion between said wire contact plane and said guide wire onthe leading end side is positioned on the base end side away from aswiveling shaft of said elevator base.
 7. The endoscope according toclaim 4, wherein a protrusion portion through which the outside diameterof said guide wire which has been elastically deformed passes when saidelevator base is swiveled and raised is provided to an opening portionof said slit, and a space in which the outside diameter of said guidewire is held in cooperation with said protrusion portion is formedinside said slit.
 8. The endoscope according to claim 7, wherein saidprotrusion portion is provided on the both sides of said opening portionof said slit.
 9. The endoscope according to claim 7, wherein saidprotrusion portion is provided in an axial direction of an insertionportion of said opening portion of said slit over the entire length. 10.The endoscope according to claim 4, wherein a slit having two opposedwall surfaces is provided on the top portion of said guide plane of saidtherapeutic instrument elevator base, and only said guide wire is fixedwhen said wall surfaces are brought into contact with only the outerperiphery of said guide wire.
 11. The endoscope according to claim 4,wherein a width of said opening portion of said slit is larger than anoutside diameter of said guide wire and smaller than an outside diameterof said therapeutic instrument externally attached to said guide wire.12. The endoscope according to claim 4, wherein a central axis of saidslit with respect to an axial direction of said insertion portion isinclined relative to a central axis of said guide plane.
 13. Theendoscope according to claim 4, wherein an intermediate stopper forstopping the operation of said operation member halfway at a position ina predetermined operation range from start of raising said therapeuticinstrument elevator base is provided, and further comprising operatingmeans for releasing said intermediate stopper to enable the operation inthe full operation range of said therapeutic instrument elevator base.14. The endoscope according to claim 13, wherein a plurality of saidintermediate stoppers are provided.
 15. The endoscope according to claim13, wherein said operating means includes a protrusion portion providedto said operation member and an elastic member engaging with aprotrusion portion.
 16. The endoscope according to claim 4, wherein,when said elevator base is swiveled to be lowered, a height of a wallsurface of an accommodation chamber of said therapeutic instrumentelevator base opposed to said slit is higher than a bottom surface ofsaid slit.
 17. The endoscope according to claim 3, wherein a wirecontact plane provided at the upper portion of an opening portion ofsaid therapeutic instrument insertion channel is included, a contactportion of said therapeutic instrument elevator base and said guide wireon the leading end side is positioned on the base end side away from aswiveling axis of said elevator base when said elevator base is swiveledand raised and said guide wire is held/fixed between said elevator baseand said wire contact plane.
 18. The endoscope according to claim 3,wherein an intermediate stopper for stopping the operation of saidoperation member halfway at a position in a predetermined operationrange from start of raising said therapeutic instrument elevator base isprovided, and said endoscope further comprises operating means forreleasing said intermediate stopper to enable the operation in the fulloperation range of said therapeutic instrument elevator base.
 19. Theendoscope according to claim 18, wherein a plurality of saidintermediate stoppers are provided.
 20. The endoscope according to claim18, wherein said operating means includes a protrusion portion providedto an operating member and an elastic member engaging with saidprotrusion portion.
 21. The endoscope according to claim 3, wherein anoperation portion is connected to a front side end portion of theinsertion portion inserted into a celoma, the end opening portion of thetherapeutic instrument insertion channel provided in said insertionportion is arranged at a distal end portion of said insertion portion,the elevator base for swiveling around a swiveling shaft provided at alower portion of said endoscope on the distal end side to raised/loweredsaid therapeutic instrument, an operation lever capable of operatingsaid elevator base, and a towing member having one end fixed to saidelevator base and the other end fixed to a rotator integrally swivelingcoaxially with said operation lever are provided; and wherein a swiveldeterrent body which is provided oppositely to said rotator andsuppresses swiveling of said rotator and a deterrence reinforcementmechanism for increasing the deterrence by the deterrent body when saidrotator rotates by the predetermined amount are provided between saidrotator and said deterrent body.
 22. The endoscope according to claim 3,wherein said constituent member is formed by a high friction resistanceportion.
 23. The endoscope according to claim 22, wherein said highfriction resistance portion is formed by embedding, for example, rubberor an elastic member having a high friction resistance.
 24. Theendoscope according to claim 22, wherein said high friction resistanceportion is formed by embedding a magnet.
 25. The endoscope according toclaim 22, wherein a detachable distal end cover in said endoscope isformed by an elastic member, and said high friction resistance portionis formed by extending said elastic member to a position at which saiddistal end cover is opposed to said therapeutic instrument elevatorbase.
 26. The endoscope according to claim 3, wherein a guide wireengagement groove in which said guide wire is fitted in is provided on aside wall of an accommodation chamber of said therapeutic instrumentelevator base.
 27. The endoscope according to claim 26, wherein a widthof said guide wire engagement groove is such that said guide wire can beelastically deformed and held in said guide wire engagement groove bypressing said guide wire between a side surface of said therapeuticinstrument elevator base and said guide wire engagement groove.
 28. Theendoscope according to claim 26, wherein a guide wall for leading saidguide wire to said guide wire engagement groove when said therapeuticinstrument elevator base is raised is provided on a guide plane of saidtherapeutic instrument elevator base.
 29. The endoscope according toclaim 26, wherein said guide wire engagement groove is provided at aposition where said guide wire is fixed so as to be inclined in thedirection along which an object optical system is arranged.
 30. Theendoscope according to claim 3, further comprising: a first impetusgiving member fixed on a proximal operation portion side of saidtherapeutic instrument channel opening portion at the distal end of saidendoscope; a second impetus giving member which is arranged beside saidfirst impetus giving member and can move substantially vertically to anaxis of said insertion portion of said endoscope; a roller for thrustingsaid second impetus giving member to said first impetus giving memberside; guide wire fixing means constituted by an elastic member arrangedbetween said first impetus giving member and said second impetus givingmember; and operating means for towing said roller.
 31. The endoscopeaccording to claim 1, wherein said guide wire fixing means is arrangedin the vicinity of said therapeutic instrument elevator base provided ata distal end of said insertion portion.
 32. The endoscope according toclaim 31, further comprising operation transmitting means includes anoperation lever provided to said operation portion and an operation wirehaving one end connected to said operation lever and the other endconnected to said guide wire fixing means.
 33. The endoscope accordingto claim 32, wherein a rotating shaft of said operation lever isprovided at a position different from the rotating shaft of elevatorbase raised lever.
 34. The endoscope according to claim 33, wherein saidrotating shaft of said operating lever is provided at a position whichis substantially orthogonal to said rotating shaft of said therapeuticinstrument elevator base raised lever.
 35. The endoscope according toclaim 33, wherein said rotating shaft of said therapeutic instrumentelevator base raised lever is provided on an axis which is substantiallyorthogonal to a central axis of said insertion portion, and saidrotating shaft of said operation lever is provided on an axis which issubstantially parallel to said central axis of said insertion portion.36. The endoscope according to claim 33, wherein a therapeuticinstrument insertion opening for leading said therapeutic instrument tosaid therapeutic instrument insertion channel is provided to a grip forholding said operation portion, and said operation lever is provided atan end portion of said grip on said insertion portion side.
 37. Theendoscope according to claim 33, wherein said therapeutic instrumentset-up lever is provided on the front side away from said grip and saidoperation lever is provided on said insertion portion side away fromsaid grip.
 38. The endoscope according to claim 31, wherein said guidewire fixing means has a snare shape.
 39. The endoscope according toclaim 38, wherein a fixing member which can temporarily fix said guidewire fixing means is provided to said endoscope in the vicinity of saidopening portion side of said therapeutic instrument insertion channel.40. The endoscope according to claim 31, wherein said guide wire fixingmeans has a hook-like shape.
 41. The endoscope according to claim 40,further comprising: a fixing portion for fixing said guide wire; a guidewire fixing member consisting of an arm portion provided on the base endside of said fixing portion and a support shaft for swiveling andsupporting said arm portion so as to be orthogonal to said arm portion;a swivel mechanism for swiveling said support shaft of said guide wirefixing member; and a tow wire which is inserted into said insertionportion of said endoscope in order to remotely operate said swivelmechanism, wherein said fixing member is brought into contact with anoutside diameter portion of said guide wire and held and fixed betweensaid outside diameter portion and a main body portion of said insertionportion at the end thereof by swiveling said arm portion.
 42. Theendoscope according to claim 41, wherein at least said support shaft andsaid swivel mechanism are water-tightly arranged inside said distal endhard portion of said endoscope.
 43. The endoscope according to claim 31,wherein a guide wire fixing elevator base capable of moving to anengagement position where said guide wire which is inserted into saidtherapeutic instrument insertion channel and guides said therapeuticinstrument is releasably engaged and an engagement releasing positionwhere engagement of said guide wire is released is provided at said endportion of said insertion portion as said guide wire fixing means. 44.The endoscope according to claim 43, wherein operating means foroperating engagement or release of said guide wire by said guide wirefixing elevator base is provided to said operation portion of saidendoscope.
 45. The endoscope according to claim 43, wherein said guidewire is held and fixed by a wall surface portion of a therapeuticinstrument insertion path arranged at the distal end of said endoscopeand said guide wire fixing elevator base.
 46. The endoscope according toclaim 43, wherein said guide wire fixing elevator base is provided onsaid therapeutic instrument elevator base for raising said therapeuticinstrument in the direction of a visual field.
 47. The endoscopeaccording to claim 43, wherein an opening portion is provided on a guideplane of said therapeutic instrument elevator base on which saidtherapeutic instrument is arranged, and said guide wire fixing elevatorbase is provided at said opening portion.
 48. The endoscope according toclaim 43, wherein said guide wire fixing elevator base is provided insuch a manner that a guide plane of said guide wire fixing elevator baseis smoothly connected to that of said therapeutic instrument elevatorbase when said guide wire fixing elevator base is lowered.
 49. Theendoscope according to claim 43, wherein a raised angle of said guidewire fixing elevator base exceeds that of said therapeutic instrumentelevator base.
 50. The endoscope according to claim 43, wherein anelastic member is provided at a guide wire contact position providedwhen said guide wire is fixed by said guide wire fixing elevator base.51. The endoscope according to claim 43, wherein a protrusion isprovided at a guide wire contact position of said elevator base providedwhen said guide wire is fixed by said guide wire fixing elevator base.52. The endoscope according to claim 31, further comprising: a biasingmember capable of moving in the direction which is substantiallyvertical to said therapeutic instrument insertion path at said distalend portion of said endoscope; guide wire fixing means constituted by aspring material assisting movement of said biasing member; and operationtransmitting means enabling operation of fixation and release of saidguide wire by said guide wire fixing means.
 53. The endoscope accordingto claim 52, wherein said guide wire fixing means is constituted byproviding a torque transmission member between said biasing member andsaid operation transmitting means.
 54. The endoscope according to claim31, wherein said guide wire fixing means is constituted by fixing an endportion of a fixing operation wire projecting from a guide pipe providedto said endoscope in the vicinity of said opening portion of saidtherapeutic instrument insertion channel on the end side.
 55. Theendoscope according to claim 54, wherein an end portion of said guidewire fixing means is fixed so as to be capable of swiveling.
 56. Theendoscope according to claim 1, wherein said guide wire fixing means isincluded in the vicinity of the distal end of said insertion portion.57. The endoscope according to claim 1, wherein said guide wire fixingmeans is arranged in the vicinity of said opening.
 58. The endoscopeaccording to claim 57, wherein said guide wire fixing means is arrangedat a position which is in contact with the vicinity of the surface ofsaid insertion portion or a position in the vicinity of the surface anda position away from an observation window arranged at the end of saidinsertion portion.
 59. The endoscope according to claim 1, wherein saidguide wire fixing means is constituted detachably with respect to saidinsertion portion.
 60. The endoscope according to claim 59, wherein saidguide wire fixing means is constituted detachably with respect to thedistal end of said insertion portion.
 61. The endoscope according toclaim 59, further comprising an attachment mechanism for attaching saidguide wire fixing means to said insertion portion.
 62. The endoscopeaccording to claim 61, wherein said attachment mechanism consists ofsoft resin such as chloroethene or rubber.
 63. The endoscope accordingto claim 61, wherein said attachment mechanism has a positioning memberconsisting of a convex portion which is fitted in said opening of saidtherapeutic instrument insertion channel.
 64. The endoscope according toclaim 61, wherein said attachment mechanism has a length extending fromat least the distal end of said insertion portion to said guide wirefixing means for covering a protrusion portion provided to said guidewire fixing means, and has a mucous protection portion from whichcorners are eliminated as a whole.
 65. The endoscope according to claim61, wherein said attachment mechanism includes: an attachment portionformed into a substantially cylindrical shape; a wall thickness varyingportion formed so as to be wall-thick toward one end in the axialdirection in said attachment portion; at least one slit which isprovided to said wall thickness varying portion and has an opening onsaid one end side; and a ring member capable of moving on at least anouter peripheral portion of said wall thickness varying portion in theaxial direction in said attachment portion, said wall thickness varyingportion being fitted to the distal end of said insertion portion in saidendoscope.
 66. The endoscope according to claim 59, further comprising aguide wire fixing member insertion channel having at the end thereof afirst opening portion which is opened at the distal end of saidtherapeutic instrument insertion channel and a second opening portionwhich is opened in the vicinity of said first opening portion, whereinsaid guide wire fixing means for holding/fixing said guide wire extendedfrom said first opening portion is extended from said second openingportion in order to guide said therapeutic instrument to saidtherapeutic target part.
 67. The endoscope according to claim 66,wherein a distal end portion of said guide wire fixing means has a snareshape.
 68. The endoscope according to claim 66, wherein a distal endportion of said guide wire fixing means has a hook shape consisting of asoft member.
 69. The endoscope according to claim 1, wherein said guidewire fixing means has guide wire fixing portions which are at least twomovable members arranged substantially in parallel to each other and canmove in the direction along which said portions move close to each otherand the direction along which said portions move away from each other.70. The endoscope according to claim 69, wherein said two guide wirefixing portions sandwich and fix said guide wire therebetween when saidguide wire fixing portions move close to each other.
 71. The endoscopeaccording to claim 1, wherein said guide wire fixing means is arrangedso as to cut across an opening of said therapeutic instrument insertionchannel in the vicinity of said opening, attached in the longitudinaldirection of said insertion portion so as to be capable of moving in thedirection along which it moves close to said therapeutic instrumentelevator base provided at said distal end portion of said endoscope andthe direction along which it moves away from the same, and has on itsplane opposed to said therapeutic instrument elevator base a guide wirefixing portion having a part with which said guide wire is brought intocontact.
 72. The endoscope according to claim 1, wherein said guide wirefixing means consists of at least one loop-like member, and a loopdiameter of said loop-like member can be enlarged and decreased.
 73. Theendoscope according to claim 1, wherein said guide wire fixing means hasa groove whose width is smaller than the outside diameter of said guidewire in some measure on its plane opposed to said therapeutic instrumentelevator base arranged at the distal end of said insertion portion. 74.The endoscope according to claim 1, wherein said guide wire fixing meanshas a guide wire fixing portion having irregularities formed thereto onits plane with which said guide wire is brought into contact.
 75. Theendoscope according to claim 74, wherein said guide wire fixing portionconsists of a pair of guide wire fixing members sandwiching said guidewire therebetween.
 76. The endoscope according to claim 75, wherein, insaid irregularities, convex portions in one guide wire fixing member arefitted in concave portions in the other guide wire fixing member. 77.The endoscope according to claim 74, wherein said irregularities consistof steps which are substantially orthogonal to said guide wire.
 78. Theendoscope according to claim 1, wherein a material which consists of anelastic member such as rubber and has the large friction resistance isarranged on a plane of said guide wire fixing means with which saidguide wire is brought into contact.
 79. The endoscope according to claim1, wherein said guide wire fixing means is arranged in a transparentsubstantially-cylindrical member having a therapeutic instrumentinsertion opening portion through which said therapeutic instrumentprojecting from the opening of said therapeutic instrument insertionchannel can pass.
 80. The endoscope according to claim 1, wherein saidguide wire fixing means has a guide wire identification mechanism foridentifying said guide wire and said therapeutic instrument other thansaid guide wire.
 81. The endoscope according to claim 80, wherein saidguide wire identification mechanism has a protrusion portion having atleast a part which protrudes on the opening of said therapeuticinstrument insertion channel so as to be capable of moving forward andbackward.
 82. The endoscope according to claim 81, wherein said guidewire identification mechanism has a protrusion portion which protrudeson the opening of said therapeutic instrument insertion channel from thebase end side in the longitudinal direction of said insertion portion soas to be capable of moving forward and backward, and said protrusionportion has a gap whose width is larger than the diameter of said guidewire on a side opposed to said guide wire.
 83. The endoscope accordingto claim 80, further comprising a guide wire fixing member or a guidewire identification member which can move with respect to said guidewire fixing means and to which impetus is given at a first positionwhere said guide wire is fixed by an elastic member or a second positionwhere said therapeutic instrument other than said guide wire can beinserted.
 84. The endoscope according to claim 83, wherein said guidewire fixing means has a click mechanism which can engage at least one ofsaid guide wire fixing member or said guide wire identification memberat said first position or said second position.
 85. The endoscopeaccording to claim 84, wherein said click mechanism consists of a clickpin and a click groove for guiding said click pin.
 86. The endoscopeaccording to claim 85, wherein said click groove has a step forpreventing reverse rotation of said click pin.
 87. The endoscopeaccording to claim 86, wherein said click pin is rotatably attached to amoving member consisting of at least either said guide wire fixingmember or said guide wire identification member, and there are provideda hole in which said click pin is fitted when said moving member reachesthe vicinity of the opposite side to that where impetus is given and astep for preventing reverse rotation at a turnback point in said clickgroove in such a manner that an outward route and an inward route ofsaid click pin are different from each other when said moving memberreciprocates between said first position and said second position. 88.The endoscope according to claim 85, wherein said click pin is rotatablyattached to a moving member consisting of at least either said guidewire fixing member and said guide wire identification member, saidendoscope includes one convex portion provided on the side where impetusis given to said guide wire fixing portion, a first convex portion and asecond convex portion provided on the opposite side to the side whereimpetus is given and a concave portion provided between said two convexportions, and steps for preventing reverse rotation are provided at allturnback points in such a manner that an outward route and an inwardroute of said click pin are different from each other when said guidewire fixing portion reciprocates between said first position and saidsecond position.
 89. The endoscope according to claim 80, wherein saidguide wire fixing means interlocks with said guide wire identificationmechanism.
 90. The endoscope according to claim 89, wherein said guidewire fixing means has a part which is caught by said guide wireidentification mechanism portion.
 91. The endoscope according to claim1, further comprising operating means for operating said guide wirefixing means.
 92. The endoscope according to claim 91, wherein saidoperating means is provided to said operation portion of said endoscope.93. The endoscope according to claim 91, wherein a transmissionmechanism for transmitting the operation of said operating means isprovided between said operating means and said guide wire fixing means.94. The endoscope according to claim 93, wherein said transmissionmechanism is an operation wire arranged in said therapeutic instrumentinsertion channel.
 95. The endoscope according to claim 93, wherein saidtransmission mechanism is arranged in an external channel providedbetween the vicinity of the distal end of said insertion portion and thefront side along the side surface of said endoscope.
 96. The endoscopeaccording to claim 95, wherein said transmission mechanism is anoperation wire arranged in said external channel.
 97. The endoscopeaccording to claim 91, wherein a member for fixing said operation wireis provided in the vicinity of the base end of a bending portion in saidendoscope.
 98. The endoscope according to claim 91, wherein saidoperating means and said endoscope operation portion are arranged so asto be distanced from each other.
 99. An endoscope comprising: aninsertion portion inserted into a celoma; an operation portion connectedto a proximal end portion of said insertion portion; and a therapeuticinstrument elevator base which is arranged at the distal end portion ofsaid insertion portion and can be operated by said operation portion,wherein a slit which can engage only a guide wire by raising said guidewire by operating said therapeutic instrument elevator base is providedat a top portion on a guide plane of said therapeutic instrumentelevator base.
 100. The endoscope according to claim 99, wherein a slithaving two opposed wall surfaces is provided on the top portion of saidguide plane of said therapeutic instrument elevator base, and only saidguide wire is fixed when said wall surfaces are brought into contactwith only the outer periphery of said guide wire.
 101. The endoscopeaccording to claim 99, wherein a width of an opening portion of saidslit is larger than the outside diameter of said guide wire and smallerthan the outside diameter of a therapeutic instrument externallyattached to said guide wire.
 102. The endoscope according to claim 99,wherein said slit is provided on the top face of a therapeuticinstrument insertion channel opening portion of an end hard portion insaid endoscope.
 103. The endoscope according to claim 99, wherein a wirecontact plane is provided on the top portion of the opening portion ofsaid therapeutic instrument insertion channel provided at the distal endof said endoscope, a contact portion of said slit and said guide wire onthe leading end side is positioned on the base end side away from aswiveling shaft of said elevator base when said elevator base isswiveled and raised and said guide wire is held/fixed between said slitand said wire contact plane.
 104. The endoscope according to claim 99,further comprising an object optical system at the distal end portion ofsaid endoscope, wherein said object optical system is set in such amanner that a part of said therapeutic instrument elevator base existsin an observation visual field when said guide wire is fixed and a partof said guide wire which is fixed and enters said observation visualfield is focused.
 105. The endoscope according to claim 99, wherein aprotrusion portion through which the outside diameter of said guide wirepasses after being elastically deformed when said elevator base isswiveled and raised is provided at the opening portion of said slit, anda space in which the outside diameter of said guide wire is held incooperation with said protrusion portion is formed inside said slit.106. The endoscope according to claim 105, wherein said protrusionportion is provided on both sides of the opening portion of said slit.107. The endoscope according to claim 105, wherein said protrusionportion is provided in the axial direction of said insertion portion ofsaid opening portion of said slit over the entire length.
 108. Theendoscope according to claim 99, wherein an intermediate stopper forstopping the operation of said operation member of said therapeuticinstrument elevator base halfway at a position in a predeterminedoperation range from start of raising said therapeutic instrumentelevator base is provided, and said endoscope further includes operatingmeans which can release said intermediate stopper and enables operationin the full operation range of said operation member.
 109. The endoscopeaccording to claim 108, wherein a plurality of said intermediate stopperare provided.
 110. The endoscope according to claim 108, wherein saidoperating means consists of a protrusion portion provided to saidoperation member and an elastic member engaging with said protrusionportion.
 111. The endoscope according to claim 99, wherein, when saidelevator base is swiveled and lowered, a height of a wall surface of anaccommodation chamber of said therapeutic instrument elevator baseopposed to said slit is higher than a bottom surface of said slit. 112.The endoscope according to claim 99, wherein said therapeutic instrumentelevator base has a guide plane which is opposed to the opening portionof said therapeutic instrument insertion channel and guides saidtherapeutic instrument, another plane facing the distal end of saidendoscope and a connection plane for smoothly connecting said guideplane with another plane, and said slit is provided on said connectionplane or from said connection plane to another plane.
 113. The endoscopeaccording to claim 99, wherein a central axis relative to an axialdirection of the insertion portion of said slit is inclined with respectto a central axis of said guide plane.
 114. An endoscope systemcomprising: an endoscope in which a therapeutic instrument insertionchannel is provided in an insertion portion inserted into a celoma, anopening portion at the distal end of said therapeutic instrumentinsertion channel is provided in the vicinity of the distal end of saidinsertion portion and a therapeutic instrument insertion opening as anopening portion of said therapeutic instrument insertion channel isprovided on the proximal side of an operation portion; a guide wirewhich can pass through said therapeutic instrument insertion channel;and a therapeutic instrument which has a pipe through which said guidewire can pass and which can be inserted into said therapeutic instrumentinsertion channel, wherein said therapeutic instrument has a protrusionlength from said distal end opening portion which is required fortreatment and a protrusion length from said therapeutic instrumentinsertion opening which is required for operation on the proximal sidewith said therapeutic instrument being inserted into said therapeuticinstrument insertion channel, guide wire fixing means for releasablyengaging said guide wire when inserting/removing said therapeuticinstrument running on said guide wire with the distal end portion ofsaid guide wire inserted through said therapeutic instrument insertionchannel being led out from said distal end opening portion is providedin the vicinity of the distal end portion of said insertion portion, andsaid guide wire has a length projecting from the proximal end portion ofsaid therapeutic instrument with the end portion of said therapeuticinstrument being drawn to the front side of said operation portion fromsaid engagement position and engaged by said guide wire fixing means.115. The endoscope system according to claim 114, wherein a slit whichcan engage only said guide wire by raising said guide wire by operatinga therapeutic instrument elevator base provided in the vicinity of theend opening portion of said therapeutic instrument insertion channel isprovided on a top portion on a guide plane of said therapeuticinstrument elevator base.
 116. The endoscope system according to claim115, further comprising a protrusion portion provided on an upperportion of the opening portion of said therapeutic instrument insertionchannel, wherein a contact portion of said protrusion portion and saidguide wire on the leading end side is positioned on the base end sideaway from a swiveling shaft of said elevator base when said elevatorbase is swiveled and raised and said guide wire is held/fixed betweensaid slit and said protrusion portion.
 117. The endoscope systemaccording to claim 115, wherein an intermediate stopper for stopping theoperation of said operation member halfway at a position in apredetermined operation range from start of raising said therapeuticinstrument elevator base is provided, and said endoscope system furtherincludes operating means which releases said intermediate stopper andcan operate in the full operation range of said operation member. 118.The endoscope system according to claim 117, wherein said operatingmeans consists of a protrusion portion provided to said operation memberand an elastic member which engages with said protrusion portion. 119.The endoscope system according to claim 115, wherein said slit has twoopposed wall surfaces and said wall surfaces are set so as to engageonly the outer peripheral surface of said guide wire.
 120. The endoscopesystem according to claim 115, wherein a width of said slit is setlarger than the outside diameter of said guide wire and smaller than theoutside diameter of a therapeutic instrument externally attached to saidguide wire.
 121. The endoscope system according to claim 115, wherein acentral axis of said slit relative to the direction of a central axis ofsaid insertion portion is inclined with respect to a central axis ofsaid guide plane.
 122. The endoscope system according to claim 114,wherein an entire length of said guide wire is set to be not more thantwofold of an entire length of said therapeutic instrument.
 123. Theendoscope system according to claim 114, wherein the entire length ofsaid guide wire is set in such a manner that said guide wire canprotrude from the opening portion of said therapeutic instrumentinsertion channel and protrude from the front end portion of saidtherapeutic instrument with the distal end portion of said therapeuticinstrument being pulled to said operation side on the proximal side fromsaid engagement position and said guide wire being fixed to said guidewire fixing means.
 124. The endoscope system according to claim 114,wherein a protrusion length of said therapeutic instrument from saidtherapeutic instrument-insertion opening is set to 30 to 60 cm in thestate where the end portion of said therapeutic instrument is pulled tosaid operation portion side on the front side from said engagementposition and said guide wire is engaged by said guide wire fixing means,and a length of said guide wire protruding from the proximal side ofsaid therapeutic instrument in the same state is set to not more than 20cm.
 125. An endoscope comprising an endoscope auxiliary instrumentattachment mechanism consisting of a belt-like member wound around saidinsertion portion.
 126. An endoscope comprising an endoscope auxiliaryinstrument attachment mechanism consisting of at least two substantiallycylindrical members, so that a second substantially cylindrical memberis movably arranged inside a first substantially cylindrical member.127. The endoscope according to claim 126, wherein at least one of aninside diameter, an outside diameter and a wall thickness in each ofsaid two substantially cylindrical members is unevenly formed.
 128. Theendoscope according to claim 126, wherein the inside diameter at one endof said first substantially cylindrical member is widened in the taperedshape so that it gradually increases toward the opening portion, and theoutside diameter at one end of said second substantially cylindricalmember is narrowly formed in the tapered shape so that it is graduallyreduced toward the opening portion.
 129. The endoscope according toclaim 126, wherein at least one slit is provided to said secondsubstantially cylindrical member.
 130. The endoscope according to claim126, wherein an engagement mechanism such as a click, a screw or afitting groove is provided so that said second substantially cylindricalmember can be temporarily held so as to be thrusted down in said firstsubstantially cylindrical member.
 131. An endoscope auxiliary instrumentattachment member comprising: an attachment portion formed into asubstantially cylindrical form; a wall thickness varying portion whichis formed so as to be gradually wall-thick toward one end of saidattachment portion in the axial direction; at least one slit which isprovided to said wall thickness varying portion and has an opening onsaid one end side; and a ring member which can move on at least an outerperipheral part of said wall thickness varying portion in the axialdirection in said attachment portion, wherein said wall thicknessvarying portion is fitted to a distal end of an insertion portion in anendoscope.
 132. A method for endoscopically performing diagnosis ortreatment by using a guide wire, said method comprising: a step forinserting said guide wire into a guide wire insertion lumen of atherapeutic instrument inserted into an endoscope; a step for grippingand fixing said guide wire on an endoscope operation portion side andpulling back said therapeutic instrument after confirming that saidguide wire has secured a lumen; a step for fixing said guide wire at adistal end of an insertion portion of said endoscope by using a guidewire fixing member after that a distal end of said therapeuticinstrument has been pulled back to the inside of said insertion portionof said endoscope; and a step for completely pulling out saidtherapeutic instrument from said endoscope after confirming that saidguide wire has been fixed.
 133. The method for performing diagnosis ortreatment according to claim 132, wherein the operation for fixing saidguide wire or for releasing fixation of the same is carried out byoperating means arranged at said operation portion of said endoscope.134. A method for endoscopically performing diagnosis or treatment byusing a guide wire, said method comprising: a step for confirming thatsaid guide wire is fixed by a guide wire fixing member at a distal endof an insertion portion of an endoscope; a step for inserting a base endside of said guide wire into a guide wire insertion lumen of atherapeutic instrument; a step for inserting said therapeutic instrumentinto said endoscope; a step for releasing fixation by said guide wirefixing member after confirming that a distal end of said therapeuticinstrument has been inserted to the vicinity of the distal end of saidinsertion portion of said endoscope; a step for gripping and fixing anendoscope operation portion side of said guide wire; and a step forfurther inserting said therapeutic instrument along said guide wire.135. The method for performing diagnosis or treatment according to claim134, wherein the operation for fixing said guide wire or releasingfixation of the same is carried out by operating means arranged to saidoperation portion of said endoscope.